The Experts below are selected from a list of 39 Experts worldwide ranked by ideXlab platform
Regli Luca - One of the best experts on this subject based on the ideXlab platform.
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Prehemorrhage antiplatelet use in aneurysmal subarachnoid hemorrhage and impact on clinical outcome
'SAGE Publications', 2021Co-Authors: Sebök Martina, Hostettler, Isabel C., Keller Emanuela, Rautalin, Ilari M., Coert, Bert A., Vandertop, William P., Post René, Sardeha Ali, Tjerkstra, Maud A., Regli LucaAbstract:Background: Literature is inconclusive regarding the association between antiplatelet agents use and outcome after aneurysmal subarachnoid hemorrhage. Aims: To investigate the association between clinical outcome and prehemorrhage use in aneurysmal subarachnoid hemorrhage patients as well as the impact of Thrombocyte Transfusion on rebleed and clinical outcome. Methods: Data were collected from prospective databases of two European tertiary reference centers for aneurysmal subarachnoid hemorrhage patients. Patients were divided into “antiplatelet-user” and “non-user” according to the use of acetylsalicylic acid prior to the hemorrhage. Primary outcome was poor clinical outcome at six months (Glasgow Outcome Scale score 1–3). Secondary outcomes were in-hospital mortality and impact of Thrombocyte Transfusion. Results: Of the 1033 patients, 161 (15.6%) were antiplatelet users. The antiplatelet users were older with higher incidence of cardiovascular risk factors. Antiplatelet use was associated with poor outcome and in-hospital mortality. After correction for age, sex, World Federation of Neurosurgical Societies score, infarction and heart disorder, pre-hemorrhage acetylsalicylic acid use was only associated with poor clinical outcome at six months (adjusted OR 1.80, 95% CI 1.08–3.02). Thrombocyte Transfusion was not associated with a reduction in rebleed or poor clinical outcome. Conclusion: In this multicenter study, the prehemorrhage acetylsalicylic acid use in aneurysmal subarachnoid hemorrhage patients was independently associated with poor clinical outcome at six months. Thrombocyte Transfusion was not associated with the rebleed rate or poor clinical outcome at six months
C Muellereckhardt - One of the best experts on this subject based on the ideXlab platform.
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intrauterine Transfusion in fetal alloimmunothrombocytopenia comparison of maternal and fetal weight adjusted igg therapy with exclusive fetal Thrombocyte Transfusion
Contributions to infusion therapy and transfusion medicine, 1997Co-Authors: G Giers, C Muellereckhardt, H Kroll, Jochen Hoch, R Bald, H Bauer, M Hansmann, P Hanfland, R E ScharfAbstract:Fetal alloimmune thrombocytopenia is caused by maternal immunization against a fetal platelet antigen and transplacental transfer of the antibody into the fetal circulation. Since 10-20% of the fetuses or newborns are threatened by intracranial hemorrhages, early management is required. Fetal blood sampling should be started between the 20th and 22nd week of gestation to assess fetal phenotype and platelet count. Different concepts to elevate the fetal platelet count have been discussed: maternal intravenous immunoglobulins, fetal intravenous immunoglobulins, or only repeated fetal platelet Transfusions. Our investigations suggested that platelet Transfusions in short intervals appear to be the only effective regimen to increase platelet counts in thrombocytopenic fetuses at risk.
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immunologic aspects of Thrombocyte Transfusion
Contributions to infusion therapy, 1991Co-Authors: C MuellereckhardtAbstract:This review surveys immunological aspects of platelet Transfusions with regard to definition of refractoriness, clinical factors influencing platelet increments, possibilities to delay or prevent immunization, antibody specificities involved in refractory states, immunological complications of platelet Transfusions and associations between production of platelet-specific antibodies (i.e. anti-Zwa and anti-Bra) and HLA class II antigens.
Sebök Martina - One of the best experts on this subject based on the ideXlab platform.
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Prehemorrhage antiplatelet use in aneurysmal subarachnoid hemorrhage and impact on clinical outcome
'SAGE Publications', 2021Co-Authors: Sebök Martina, Hostettler, Isabel C., Keller Emanuela, Rautalin, Ilari M., Coert, Bert A., Vandertop, William P., Post René, Sardeha Ali, Tjerkstra, Maud A., Regli LucaAbstract:Background: Literature is inconclusive regarding the association between antiplatelet agents use and outcome after aneurysmal subarachnoid hemorrhage. Aims: To investigate the association between clinical outcome and prehemorrhage use in aneurysmal subarachnoid hemorrhage patients as well as the impact of Thrombocyte Transfusion on rebleed and clinical outcome. Methods: Data were collected from prospective databases of two European tertiary reference centers for aneurysmal subarachnoid hemorrhage patients. Patients were divided into “antiplatelet-user” and “non-user” according to the use of acetylsalicylic acid prior to the hemorrhage. Primary outcome was poor clinical outcome at six months (Glasgow Outcome Scale score 1–3). Secondary outcomes were in-hospital mortality and impact of Thrombocyte Transfusion. Results: Of the 1033 patients, 161 (15.6%) were antiplatelet users. The antiplatelet users were older with higher incidence of cardiovascular risk factors. Antiplatelet use was associated with poor outcome and in-hospital mortality. After correction for age, sex, World Federation of Neurosurgical Societies score, infarction and heart disorder, pre-hemorrhage acetylsalicylic acid use was only associated with poor clinical outcome at six months (adjusted OR 1.80, 95% CI 1.08–3.02). Thrombocyte Transfusion was not associated with a reduction in rebleed or poor clinical outcome. Conclusion: In this multicenter study, the prehemorrhage acetylsalicylic acid use in aneurysmal subarachnoid hemorrhage patients was independently associated with poor clinical outcome at six months. Thrombocyte Transfusion was not associated with the rebleed rate or poor clinical outcome at six months
Germans M R - One of the best experts on this subject based on the ideXlab platform.
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Management of aneurysmal subarachnoid hemorrhage patients with antiplatelet use before the initial hemorrhage: an international survey
Elsevier, 2018Co-Authors: Sebök M, Keller E, Van Niftrik C H B, Regli L, Germans M RAbstract:INTRODUCTION The case fatality in aneurysmal subarachnoid hemorrhage (aSAH) is 50% due to the initial hemorrhage or subsequent complications like aneurysmal rebleed or delayed cerebral ischemia (DCI). One factor that might influence the initial brain damage or subsequent complications is the use of antiplatelet medication before the initial hemorrhage. The goal of this survey was to assess the different management options of patients with aSAH with antiplatelet use before the initial hemorrhage. MATERIAL AND METHODS An anonymous survey of 11 multiple-choice questions about management of aSAH patients with antiplatelet use before the initial hemorrhage was distributed to the international panel of attendees of the European Association of Neurosurgical Societies (EANS) annual meeting in Venice, Italy at 1-5 October 2017. RESULTS A total of 258 (54%) completed surveys were returned. In about 80%, the departments of neurosurgery and neurology were responsible for acute management of aSAH patients, whereas in 15% the intensive care unit. Department guidelines were present in 32%. In 65%, the responders always stop the antiplatelet agent at admission and in 4.3% are Thrombocytes always transfused. When a guideline is present, the neurospecialists consider Thrombocyte Transfusion more often (83% vs. 65% p=0.02). CONCLUSION Our survey among mainly European neurosurgeons show that there is a significant variability in the management of aSAH patients who have been using antiplatelets before the initial hemorrhage. These findings emphasize the importance of the development of evidence-based guidelines for management of patients with aSAH and antiplatelet use before the initial hemorrhage
R E Scharf - One of the best experts on this subject based on the ideXlab platform.
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intrauterine Transfusion in fetal alloimmunothrombocytopenia comparison of maternal and fetal weight adjusted igg therapy with exclusive fetal Thrombocyte Transfusion
Contributions to infusion therapy and transfusion medicine, 1997Co-Authors: G Giers, C Muellereckhardt, H Kroll, Jochen Hoch, R Bald, H Bauer, M Hansmann, P Hanfland, R E ScharfAbstract:Fetal alloimmune thrombocytopenia is caused by maternal immunization against a fetal platelet antigen and transplacental transfer of the antibody into the fetal circulation. Since 10-20% of the fetuses or newborns are threatened by intracranial hemorrhages, early management is required. Fetal blood sampling should be started between the 20th and 22nd week of gestation to assess fetal phenotype and platelet count. Different concepts to elevate the fetal platelet count have been discussed: maternal intravenous immunoglobulins, fetal intravenous immunoglobulins, or only repeated fetal platelet Transfusions. Our investigations suggested that platelet Transfusions in short intervals appear to be the only effective regimen to increase platelet counts in thrombocytopenic fetuses at risk.