Hämostaseologie最新文献

Perioperative Management for Port Catheter Procedures in Pediatric Patients with Severe Hemophilia and Inhibitors 严重血友病和抑制剂儿科患者端口导管手术的围手术期管理

Hämostaseologie Pub Date : 2024-09-12 DOI: 10.1055/a-2337-3687

Anna Woestemeier, Silvia Horneff, Vincent Marlon Lüder, Jennifer Nadal, Arne Koscielny, Jörg C. Kalff, Johannes Oldenburg, Georg Goldmann, Philipp Lingohr

{"title":"Perioperative Management for Port Catheter Procedures in Pediatric Patients with Severe Hemophilia and Inhibitors","authors":"Anna Woestemeier, Silvia Horneff, Vincent Marlon Lüder, Jennifer Nadal, Arne Koscielny, Jörg C. Kalff, Johannes Oldenburg, Georg Goldmann, Philipp Lingohr","doi":"10.1055/a-2337-3687","DOIUrl":"https://doi.org/10.1055/a-2337-3687","url":null,"abstract":"\u0000Background The objective of this systematic study was to assess the perioperative management and outcome of surgery in pediatric patients with hemophilia A/B and inhibitors compared to nonhemophilic pediatric patients. \u0000Methods The surgical outcome of 69 port catheter operations in patients with hemophilia who developed inhibitory antibodies against the administered factor was compared to 51 procedures in the control group. In the patients with hemophilia and inhibitors, a standardized protocol for recombinant activated factor VII was used to prevent perioperative bleeding. \u0000Results Hemophilic pediatric patients with inhibitors showed no significant differences in perioperative management (blood transfusion: p = 0.067, duration of surgery: p = 0.69; p = 0.824) in comparison to patients without hemophilia. The length of hospital stay was significantly longer in pediatric patients with hemophilia and inhibitors (20 days vs. 4 days for insertion; 12 days vs. 1 day for explantation). Moreover, no statistically significant difference was found for secondary bleeding (three patients with hemophilia vs. none in the control group; p = 0.11) or surgical complications (five hemophilia patients vs. none with grade I complication; one hemophilia patient vs. none with grade II complications; p = 0.067). \u0000Conclusion This study has demonstrated that port catheter insertion and removal is safe in these patients. Moreover, it shows the importance of a coordinated approach with a multidisciplinary team. ","PeriodicalId":501645,"journal":{"name":"Hämostaseologie","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reform des Kapitels 32 (Laboratoriumsmedizin) im einheitlichen Bewertungsmaßstab (EBM) 改革标准评估表（EBM）第 32 章（检验医学）的内容

Hämostaseologie Pub Date : 2024-07-02 DOI: 10.1055/a-2239-0750

Günther Kappert, Jürgen Koscielny, Christoph Sucker

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Pulmonary Embolism: An Update Based on the Revised AWMF-S2k Guideline 肺栓塞：基于 AWMF-S2k 指南修订版的更新

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/s-0044-1779011

Christian F. Opitz, F. Joachim Meyer

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Thrombozyten: Blutstillung ohne Gerinnselbildung 血栓细胞：止血但不形成血块

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/a-2280-1098

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Recurrent Venous Thromboembolism in Patients on Anticoagulation: An Update Based on the Revised AWMF S2k Guideline 接受抗凝治疗患者的复发性静脉血栓栓塞症：基于修订版 AWMF S2k 指南的更新

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/a-2173-7729

Robert Klamroth, Hanno Riess, Jan Beyer-Westendorf, Birgit Linnemann

{"title":"Recurrent Venous Thromboembolism in Patients on Anticoagulation: An Update Based on the Revised AWMF S2k Guideline","authors":"Robert Klamroth, Hanno Riess, Jan Beyer-Westendorf, Birgit Linnemann","doi":"10.1055/a-2173-7729","DOIUrl":"https://doi.org/10.1055/a-2173-7729","url":null,"abstract":"In the recently updated German S2k Guideline “Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism,” a new chapter was incorporated about recurrent venous thromboembolism (VTE) in patients on anticoagulation treatment. Despite the high efficacy of anticoagulation in most patients, approximately 2% experience a recurrent VTE event while receiving anticoagulant drugs. The proper diagnosis of the recurrent VTE is important and possible only with the knowledge of localization and thrombus burden of the primary VTE event. Possible reasons for recurrent VTE events in patients on anticoagulation are non-adherence to medication, sub-therapeutic drug levels due to resorption disorders or drug interactions, or concomitant disease with high thrombogenicity. Cancer is the most common underlying disease, but it is important to investigate and understand possible other causes whenever a breakthrough VTE event occurs. This results in the recommendation that in patients with VTE recurrence on therapeutic anticoagulation, in particular, the presence of malignant disease, antiphospholipid syndrome, and rare diseases like paroxysmal nocturnal hemoglobinuria or Behçet's disease should be considered. For VTE recurrence during heparin therapy, heparin-induced thrombocytopenia type II needs to be ruled out, even if platelet counts are within the normal range. Although the mechanisms of recurrence on anticoagulation can be evaluated in a certain degree, clinical evidence for the management of recurrent VTE in anticoagulated patients is minimal and mainly based on expert opinion. Switching anticoagulant medication and intensifying anticoagulant treatment are possible options. ","PeriodicalId":501645,"journal":{"name":"Hämostaseologie","volume":"171 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140837566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Management of Deep Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline 深静脉血栓的管理：根据修订后的 AWMF S2k 指南进行更新

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/a-2178-6574

Birgit Linnemann, Jan Beyer-Westendorf, Christine Espinola-Klein, Katja S. Mühlberg, Oliver J. Müller, Robert Klamroth

{"title":"Management of Deep Vein Thrombosis: An Update Based on the Revised AWMF S2k Guideline","authors":"Birgit Linnemann, Jan Beyer-Westendorf, Christine Espinola-Klein, Katja S. Mühlberg, Oliver J. Müller, Robert Klamroth","doi":"10.1055/a-2178-6574","DOIUrl":"https://doi.org/10.1055/a-2178-6574","url":null,"abstract":"Deep vein thrombosis (DVT) and pulmonary embolism (PE) are the most common manifestations of venous thromboembolism (VTE). Most DVTs affect the lower-extremity veins. Since the symptoms of DVT are non-specific, a prompt and standardised diagnostic work-up is essential to minimise the risk of PE in the acute phase and to prevent thrombosis progression, post-thrombotic syndrome and VTE recurrence in the long-term. Only recently, the AWMF S2k guidelines on Diagnostics and Therapy of Venous Thrombosis and Pulmonary Embolism have been revised. In the present article, we summarize current evidence and guideline recommendations focusing on lower-extremity DVT (LEDVT). Depending on whether the diagnostic work-up is performed by a specialist in vascular medicine or by a primary care physician, different diagnostic algorithms are presented that combine clinical probability, D-dimer testing and diagnostic imaging. The diagnosis of ipsilateral recurrent DVT poses a particular challenge and is presented in a separate algorithm. Anticoagulant therapy is an essential part of therapy, with current guidelines clearly favouring regimens based on direct oral anticoagulants over the traditional sequential therapy of parenteral anticoagulants and vitamin K antagonists. For most DVTs, a duration of therapeutic-dose anticoagulation of at least 3 to 6 months is considered sufficient, and this raises the question of the risk of VTE recurrence after discontinuation of anticoagulation and the need for secondary prophylaxis in the long-term. Depending on the circumstances and trigger factors that have contributed to the occurrence of DVT, management strategies are presented that allow decision-making taking into account the individual bleeding risk and patient's preferences. ","PeriodicalId":501645,"journal":{"name":"Hämostaseologie","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Current Topics from the Revised German S2k Guideline on Diagnosis and Treatment of Venous Thromboembolism 静脉血栓栓塞症诊断与治疗德国 S2k 指南修订版中的当前主题

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/a-2239-0770

Birgit Linnemann, Robert Klamroth

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Efgartigimod hilft bei Immunthrombozytopenie 依法加替莫德有助于治疗免疫性血小板减少症

Hämostaseologie Pub Date : 2024-04-30 DOI: 10.1055/a-2280-1083

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Circulating Tumor Cells and Thromboembolic Events in Patients with Glioblastoma 胶质母细胞瘤患者的循环肿瘤细胞与血栓栓塞事件

Hämostaseologie Pub Date : 2024-04-18 DOI: 10.1055/a-2251-6766

Christina C. Rolling, Malte Mohme, Carsten Bokemeyer, Manfred Westphal, Sabine Riethdorf, Katrin Lamszus, Klaus Pantel, Felix Klingler, Florian Langer

{"title":"Circulating Tumor Cells and Thromboembolic Events in Patients with Glioblastoma","authors":"Christina C. Rolling, Malte Mohme, Carsten Bokemeyer, Manfred Westphal, Sabine Riethdorf, Katrin Lamszus, Klaus Pantel, Felix Klingler, Florian Langer","doi":"10.1055/a-2251-6766","DOIUrl":"https://doi.org/10.1055/a-2251-6766","url":null,"abstract":"Patients with glioblastoma (GBM) are at increased risk for arterial and venous thromboembolism (TE). Risk factors include surgery, the use of corticosteroids, radiation, and chemotherapy, but also prothrombotic characteristics of the tumor itself such as expression of tissue factor, vascular endothelial growth factor, or podoplanin. Although distant metastases are extremely rare in this tumor entity, circulating tumor cells (CTCs) have been detected in a significant proportion of GBM patients, potentially linking local tumor growth characteristics to systemic hypercoagulability. We performed post hoc analysis of a study, in which GBM patients had been investigated for CTCs. Information on TE was retrieved from electronic patient charts. In total, 133 patients (median age, 63 years; interquartile range, 53–70 years) were analyzed. During follow-up, TE was documented in 14 patients (11%), including 8 venous and 6 arterial events. CTCs were detected in 26 patients (20%). Four (15%) patients with CTCs had a TE compared with 10 (9%) patients without CTCs. There was no difference in the frequency of TE events between patients with and those without detectable CTCs (p = 0.58). In summary, although our study confirms a high risk of TE in GBM patients, it does not point to an obvious association between CTCs and vascular thrombosis. ","PeriodicalId":501645,"journal":{"name":"Hämostaseologie","volume":"201 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140627702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Programm für die Veranstaltung des BDDH im Rahmen der 68. Jahrestagung der Gesellschaft für Thrombose- und Hämostaseforschung in Wien 2024 und Petition an den Deutschen Bundestag aufgrund eines drohenden Praxenkollaps 作为在维也纳举行的血栓与止血研究学会第 68 届年会一部分的 BDDH 活动计划 2024 年，以及因医疗实践即将崩溃而向德国联邦议院提交的请愿书

Hämostaseologie Pub Date : 2023-12-14 DOI: 10.1055/a-2031-8165

Jürgen Koscielny, Günther Kappert, Christoph Sucker

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