Podcasts about haemostasis

research journal syndrome pts statins rcts dvt thrombosis thrombotic haemostasis

Play Episode Listen Later May 26, 2023 13:43

Join us for an in-depth conversation with Dr Lucia Caiano and Dr Tzu-Fei Wang, two of the authors of a review exploring the potential role of statins in preventing post-thrombotic syndrome (PTS), a frequent long-term complication of deep vein thrombosis (DVT). They dive into their systematic review and meta-analysis, discussing the intriguing findings drawn from 1971 screened records. The interview reveals their insightful interpretations of data, including the possible 22% reduction of PTS incidence with statin use. Yet, they also acknowledge the limitations seen in randomized controlled trials (RCTs). The conversation offers an invaluable opportunity to better understand the challenges of PTS prevention, the promising role of statins, and the crucial need for larger RCTs to confirm these findings. Don't miss this chance to gain expert insights into this rapidly developing field of medical research.Contact us on Twitter:@ThrombosisCan@TzufeiWangRef:Caiano L, Drury T, Zahrai A, Wang TF, Siegal DM, Rodger MA, Fournier K, Delluc A. Role of statins in the prevention of post-thrombotic syndrome after a deep venous thrombosis event: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis. 2022 Dec 22.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Diagnosing Glanzmann's Thrombasthenia

Bruised Not Broken: Life with Glanzmann's Thrombasthenia

Play Episode Listen Later Mar 29, 2023 29:59 Transcription Available

April's episode of Bruised Not Broken: Life with Glanzmann's Thrombasthenia features Dr. Alan Michelson.Dr. Michelson's achievements throughout his almost 50-year career in medicine are numerous. He is currently Professor of Pediatrics and Medicine, Emeritus at Harvard Medical School. He also serves as the Center for Platelet Research Studies' Director Emeritus. He was formerly the Director of the Thrombosis and Anticoagulation Program at Dana-Farber/Boston Children's Cancer and Blood Disorders Center.Dr. Michelson is the editor of the highly awarded textbook Platelets (Elsevier/Academic Press), which integrates the entire field of platelet biology, pathophysiology, and clinical medicine into a comprehensive source of knowledge about platelets for clinicians, pathologists, and scientists. And in 2019, he received the 1st Annual Esteemed Career Award from the International Society on Thrombosis and Haemostasis.Dr. Michelson's work with Glanzmann's Thrombasthenia is well-known and highly respected in the medical world. He has diagnosed and treated many with GT, some of who traveled specifically to see him. Though he doesn't see patients anymore, Dr. Michelson is still a wealth of knowledge for those navigating a Glanzmann's diagnosis. Want to Sponsor the Podcast? Contact Us Here Have GT? Join Our Support Group Visit Our Website

director professor medicine cancer harvard medical school pediatrics gt international society diagnosing emeritus michelson thrombosis director emeritus haemostasis

Thrombotic & Bleeding Outcomes following AC interruption in NVAF and Ca with Dr Joseph Shaw & Dr Tzu-Fei Wang

Play Episode Listen Later Mar 3, 2023 25:45

Don't miss our latest podcast interview with Dr Joseph Shaw and Dr Tzu-Fei Wang who discuss insights from their single-center retrospective cohort study, which included 264 patients with nonvalvular AF and Cancer undergoing 302 periprocedural interruptions. Learn about the primary endpoints, which were the 30-day risks of arterial thromboembolism and major bleeding, and the results that showed relatively low risk for these complications when patients were managed according to commonly applied perioperative management recommendations. Tune in now to gain valuable knowledge on this important topic.Aziz, Joseph, et al. "Thrombotic and Bleeding Outcomes Following the Perioperative Interruption of Anticoagulation Among Patients with Non-Valvular Atrial Fibrillation and Active Cancer." Journal of Thrombosis and Haemostasis (2022).Follow us on TwitterDr Shaw: @JRand083Dr Wang: @TzufeiWang@thrombosiscanada.cawww.thrombosiscanada.caSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

cancer journal outcomes af wang bleeding interruption aziz thrombosis thrombotic haemostasis joseph shaw nvaf

DOACs vs VKAs in thrombotic APS - Dr Jean Connors & Dr Behnood Bikdeli

Play Episode Listen Later Feb 3, 2023 20:29

In this interview, two of the authors of the paper Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials, Dr Jean Connors and Dr Benhood Bikdeli, provide listeners with an overview of their systematic review and meta-analysis that evaluated the efficacy and safety of direct oral anticoagulants (DOACs) compared to vitamin K antagonists (VKAs) in patients with thrombotic antiphospholipid syndrome. The authors searched through three databases (PubMed, EMBASE, and Cochrane Central Register of Controlled Trials) and found four eligible randomized controlled trials with a total of 472 patients. Our podcast guests discuss the results of the study and the clinical implications. About our guests:Dr Jean M Connors: Jean M. Connors, MD is a hematology attending at Brigham and Women's Hospital and Dana-Farber Cancer Institute; the Medical Director of the Anticoagulation Management Services, and the Hemostatic Antithrombotic Stewardship Program; and an Associate Professor of Medicine at Harvard Medical School. She received a medical degree from The Johns Hopkins University in Baltimore, completed her residency in internal medicine at Beth Israel Deaconess Medical Center in Boson, as well as fellowships in transfusion medicine and hematology & oncology from Brigham and Women's Hospital.Dr. Connors is an Associate Editor for the Journal of Thrombosis and Haemostasis and the Journal of the American College of Cardiology: Basic to Translational Science. She is a member of or holds a leadership role in many professional societies, including ASH and ISTH. She has participated in numerous clinical trials for patients with venous thrombosis in cancer, and anticoagulation questions in general.Dr Benhood Bikdeli:Behnood Bikdeli, MD, MS is a clinician-investigator, with training in cardiology and in vascular medicine who is particularly interested in thrombotic diseases. He is an Associate Physician in the Division of Cardiovascular Medicine at Brigham and Women's Hospital, an Instructor in Medicine at Harvard Medical School, and an investigator at Yale Center for Outcomes Research and Evaluation (CORE). His research has been funded by the NIH, the American Heart Association, Brigham and Women's Hospital and others. Dr Bikdeli has coauthored over 180 publications, which have been published in journals including Lancet, JAMA, JAMA Internal Medicine, Circulation, Journal of the American College of Cardiology, the British Medical Journal, and others. Dr. Bikdeli was the lead author of two international consensus documents related to thrombosis in COVID-19, is the joint principal investigator of the INSPIRATION/ INSPIRATION-S randomized controlled trial, and is an Associate Editor for Thrombosis Research. Ref:Khairani, C. D., Bejjani, A., Piazza, G., Jimenez, D., Monreal, M., Chatterjee, S., ... & Bikdeli, B. (2022). Direct oral anticoagulants vs vitamin-K antagonists in thrombotic antiphospholipid syndrome: meta-analysis of randomized controlled trials. Journal of the American College of Cardiology.Follow us on Twitter:@thrombosiscan@connors_mdSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Antithrombotic Stewardship with Dr Maral Koolian & Ryan Kerzner

Play Episode Listen Later Jan 19, 2023 36:33

Are you curious about how to improve the safety and effectiveness of anticoagulant prescriptions for hospitalized patients? Join us for an exclusive interview with two of the authors (Dr Maral Koolian and Pharmacist Ryan Kerzner ) of a groundbreaking study on anticoagulation stewardship program at the Montreal Jewish General Hospital. Our guests will share their findings on the success rate of recommendations made by a multidisciplinary team of physicians and pharmacists, as well as the most common types of adjustments made to prescriptions. Don't miss this opportunity to learn more about the potential benefits of these programs and the future research needed to fully understand their impact on patient outcomes. Download this episode today!Koolian, M., Wiseman, D., Mantzanis, H., Kampouris, N., Kerzner, R. S., & Kahn, S. R. (2022). Anticoagulation stewardship: Descriptive analysis of a novel approach to appropriate anticoagulant prescription. Research and Practice in Thrombosis and Haemostasis, 6(6), e12758. Guest Biographies: Dr Maral Koolian is an Assistant Professor of Medicine and the Director of the Adult Thrombosis Medicine AFC program at McGill University. She is a member of the Division of General Internal Medicine and the Centre of Excellence in Thrombosis and Anticoagulation Care (CETAC) at the Jewish General Hospital. She earned her medical degree at McGill University, where she subsequently completed post-graduate subspecialty training in General Internal Medicine. She then completed a 1-year clinical thrombosis fellowship at the University of Ottawa, followed by an MSc in Quality Improvement and Patient Safety at the University of Toronto. Her main research focus is quality improvement principles as they apply to venous thromboembolic disease and anticoagulation management. Ryan Kerzner graduated with a Bachelor of Pharmacy and a Masters in hospital pharmacy from the Université de Montréal. He has been a pharmacist at the Jewish General Hospital in Montreal since 2008. He is one of the co-founders of the hospital's Antimicrobial Stewardship programs, in which he is still actively involved. He also works in Internal Medicine where he developed an interest in Thrombosis medicine. He officially joined the hospital's CETAC team in 2019, which is the Centre of Excellence in Thrombosis & Anticoagulation Care. In CETAC, with Dr Koolian and 2 other thrombosis pharmacists, he was involved in the development an Anticoagulation Stewardship Program. Follow us on Twitter@thrombosiscan@MKoolian@Pharmacist_MTLCheck out the resources on https://thrombosiscanada.caSupport the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Diagnosis & Mgmt of SCPCD with Dr M Othman & Dr L Brandao

Play Episode Listen Later Jan 6, 2023 31:39

In this episode we interview two of the authors of a recent paper, Diagnosis and management of severe congenital protein C deficiency (SCPCD): Communication from the SSC of the ISTH, Dr Maha Othman and Dr Leonardo Brandao on this paper from the Journal of Thrombosis and Haemostasis. 2022;20:1735–1743. Severe congenital protein C deficiency (SCPCD) is rare and there is currently substantial variation in the management of this condition. A joint project by three Scientific and Standardization Committees of the ISTH was developed to review the current evidence and help guide on diagnosis and management of SCPCD.About our guests:Dr. Maha Othman is a clinical pathologist/hematologist with specialized training in haemostasis laboratory testing and molecular genetics of bleeding disorders. She obtained her medical degree and MSc in Clinical Pathology in Mansoura University in Egypt. She then completed her PhD in Pathology from Southampton University, UK. After this, she pursued post-doctoral research training in molecular genetics of hemophilia and von Willebrand disease with Dr. David Lillicrap, at Queen's University, Canada. Dr. Othman is currently a full Professor at the School of Medicine, Queen's University and at St Lawrence College, Kingston, Ontario. Her research interests include the clinical and molecular aspects of von Willebrand disease and platelet disorders particularly PT-VWD, and thromboelastography assessment of coagulopathies in women, pregnancy and cancer. She has more than 100 research papers and her research is recognized internationally. She is an editor for Seminars in Thrombosis and Haemostasis and Research and Practice in Thrombosis and Haemostasis Journals. She is a reviewer for a number of Haemostasis journals and a member of several scientific organizing committees on women's health, and advisory boards for international haemostasis conferences. She is the previous Chairman of the Scientific and Standardization Committee (SSC) on Women's Health Issues in Thrombosis and Haemostasis of the ISTH and currently CO-Chair on the SSC for DIC. She is a passionate educator and mentor and an advocate for rare bleeding disorders and bleeding and clotting disorders in women.Dr. Leonardo Brandão is a native Brazilian who joined the staff at The Hospital for Sick Children in 2004. Since 2019, he has been the Thrombosis Program director. He obtained his medical degree at the University of São Paulo (USP) School of Medicine (FMUSP) before moving to North America, where he completed his post-graduate training (Paediatrics Residency at Emory University, Atlanta/GA, Paediatric Haematology/Oncology fellowship at St. Jude Children's Research Hospital, Memphis/TN, and a second fellowship in Paediatric Coagulation at Weill Cornell University, New York/NY). After finishing his training, he moved to Canada to focus on the field of paediatric thrombosis at SickKids. He is the past-chair of the thrombosis committee for the Canadian Pediatric Thrombosis Hemostasis Network (CPTHN), past-Canadian representative-elect for the Hemostasis and Thrombosis Research Society (HTRS), past-member of the first paediatric venous thromboembolism panel for the American Society of Hematology (ASH), past-co-chair of the paediatric thrombosis subcommittee for the International Society on Thrombosis and Hemostasis (ISTH), and a member of Thrombosis Canada. Links:Thrombosis Canada Clinical Guide:Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

S4E1 - Women's health series (part 1): Women's health and coagulation

Play Episode Listen Later Jan 3, 2023 9:15

Welcome to Ask Stago, the Podcast dedicated to provide expert answers to your expert questions in coagulation. In this series of our new season we will be covering Womens' health and looking at the broader implications of coagulation and then speaking to a Lupus patient advocate on the impact this disease has had for her personally. To start off, in today episode, we are delighted to speak to our Clinical Development Director, Dr Francois Depasse about the broader connection between Womens' Health and coagulation and then a more in depth look at APS. Links to related podcasts: S1E13 - Lupus anticoagulant diagnosis work-up https://www.podcastics.com/podcast/episode/13-the-lupus-anticoagulant-diagnosis-work-up-54015/ S3E7 - Hemostasis results interpretation along pregnancy https://www.podcastics.com/podcast/episode/s3e7-hemostasis-results-interpretation-along-pregnancy-134753/ Literature sources: https://www.cdc.gov/ncbddd/blooddisorders/women/facts.html Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, De Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306 Devreese KMJ, Ortel TL, Pengo V, de Laat B; Subcommittee on Lupus anticoagulant/Antiphospholipid antibodies. Laboratory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH. J Thromb Haemost 2018; 16: 809-813 CLSI Laboratory testing for the Lupus anticoagulant - Approved Guideline. CLSI document H60-A. Wayne, PA; 2014. Devreese, KMJ, de Groot, PG, de Laat, B, et al. Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis. J Thromb Haemost. 2020; 18: 2828– 2839. https://doi.org/10.1111/jth.15047 Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice.

S3E11 - What is Factor parallelism for?

Play Episode Listen Later Nov 8, 2022 11:04

Welcome to Ask Stago, the Podcast dedicated to provide expert answers to your expert questions in coagulation. In today's episode, our guest Tom Childs will help us to understand the goal and clinical benefits of the Factor parallelism method. Link to previous podcasts: S1E11 – How to be more productive (part 1): implementation of a rules engine S2E8 - World Hemophilia Day S2E4 - How to determine factor levels in hemophilia? Literature sources: Ma AD, Carrizosa D. Acquired factor VIII inhibitors: pathophysiology and treatment. Hematology Am Soc Hematol Educ Program 2006: 432–7 (https://ashpublications.org/hematology/article/2006/1/432/19703/Acquired-Factor-VIII-Inhibitors-Pathophysiology). Morfini M. Articular status of haemophilia patients with inhibitors. Haemophilia 2008; 14 (Suppl 6): 20–2. Gringeri A, Mantovani LG, Scalone L, Mannucci PM; COCIS Study Group. Cost of care and quality of life for patients with hemophilia complicated by inhibitors: the COCIS Study Group. Blood 2003; 102 (7): 2358–63 Monahan PE, Baker JR, Riske B, Soucie JM. Physical functioning in boys with hemophilia in the U.S. Am J Prev Med 2011; 41 (6 Suppl 4): S360–8. Collins PW, Chalmers E, Hart D et al.; United Kingdom Haemophilia Centre Doctors' Organization. Diagnosis and management of acquired coagulation inhibitors: a guideline from UKHCDO. Br J Haematol 2013; 162 (6): 758–73 (https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.12463). Riley PW, Gallea B, Valcour A. Development and implementation of a coagulation factor testing method utilizing autoverification in a high‑volume clinical reference laboratory environment. J Pathol Inform 2017; 8: 25. Witmer C, Young G. Factor VIII inhibitors in hemophilia A: rationale and latest evidence. Ther Adv Hematol 2013; 4 (1): 59–72 Oldenburg J, Mahlangu JN, Kim B et al. Emicizumab prophylaxis in hemophilia A with inhibitors. N Engl J Med 2017; 377 (9): 809–18. Florin L, Desloovere M, Devreese KML. Validation of an automated algorithm for interpretation of lupus anticoagulant testing on the Stago STA R Max (Poster). International Society on Thrombosis and Haemostasis, 2017. Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice.

Emofilia, profilassi fitusiran riduce sanguinamenti del 61%

Ultim'ora

Play Episode Listen Later Sep 9, 2022 3:07

Durante il 30° congresso dell'International Society on Thrombosis and Haemostasis 2022 sono stati presentati i dati dello studio di fase 3 ATLAS-PPX che valuta l'efficacia e la sicurezza di fitusiran da 80 mg una volta al mese in adulti e adolescenti affetti da emofilia A o B grave, precedentemente trattati con una profilassi a base di fattori o di agenti bypassanti. col/sat/gsl

durante thrombosis haemostasis emofilia

2022 CHEST Perioperative Guidelines with Dr J Douketis

professor medicine fellow guidelines chest health sciences internal medicine past presidents associate editor mcmaster university annals deputy editor perioperative thrombosis general internal medicine canadian journal canadian academy staff physician haemostasis

Play Episode Listen Later Aug 26, 2022 21:00

In this episode we will be discussing a recent paper published in CHEST entitled Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline with lead author Dr Jim Douketis. Dr. Douketis is Staff Physician in General Internal Medicine and Clinical Thromboembolism at St. Joseph's Healthcare Hamilton. He is a Professor of Medicine and holds the David Braley-Nancy Gordon Chair in Thromboembolic Disease at McMaster University. Dr Douketis is past-president of Thrombosis Canada.Dr. Douketis' research interests include perioperative antithrombotic therapy, prognosis of patients with venous thromboembolism, hormonal therapy and thrombosis, prevention of venous thrombosis in medical patients, and clinical practice guideline development.Dr. Douketis is a Fellow of the Canadian Academy of Health Science, Past-President of Thrombosis Canada, Associate Editor of McMaster Textbook of Internal Medicine, Editor-in-Chief of Canadian Journal of General Internal Medicine, Deputy Editor of Annals of Internal Medicine ACP Journal Club, and Associate Editor of Thrombosis and Haemostasis. He has over 350 peer-reviewed publications.Follow us on Twitter;Thrombosis Canada: @ThrombosisCanReference:Douketis JD, Spyropoulos AC, Murad MH, Arcelus JI, Dager WE, Dunn AS, Fargo RA, Levy JH, Samama CM, Shah SH, Sherwood MW. Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline. Chest. 2022 Aug 11.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Platelets and their role in haemostasis

ANZCA Part 1 SAQs

Play Episode Listen Later Jul 28, 2022 2:19

So much rote learning that means nothing

platelets haemostasis

New GI Guidelines on Management of GI Bleeds with Alan Barkun & Jim Douketis

Play Episode Listen Later Jun 16, 2022 36:11

In this episode we discuss a recent paper published jointly in The American Journal of Gastroenterology and the Journal of the Canadian Association of Gastroenterology entitled American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period and co-authored by a Canada – United States team of experts.The interview with co-authors Dr Alan Barkun and Dr Jim Douketis covers the rationale for the new guidelines as well as the implications for clinicians. Dr Barkun is Professor of Medicine in the Division of Gastroenterology at McGill University and the McGill University Health Centre, Montréal, Canada. He is current holder of the DG Kinnear Chair in Gastroenterology at McGill University. Recipient of many national and international awards, Dr. Barkun has published over 400 peer-reviewed articles and abstracts and has given over 600 international presentations on emerging digestive endoscopic technologies, with an emphasis on methodological, clinical and cost-effectiveness trials of treatments for upper gastrointestinal bleeding (UGIB), bilio-pancreatic diseases and colorectal cancer screening. He is also the current President of the colorectal Cancer screening implementation committee for the province of Quebec. ANDDr. Douketis is Staff Physician in General Internal Medicine and Clinical Thromboembolism at St. Joseph's Healthcare Hamilton. He is a Professor of Medicine and holds the David Braley-Nancy Gordon Chair in Thromboembolic Disease at McMaster University. Dr Douketis is past-president of Thrombosis Canada.Dr. Douketis' research interests include perioperative antithrombotic therapy, prognosis of patients with venous thromboembolism, hormonal therapy and thrombosis, prevention of venous thrombosis in medical patients, and clinical practice guideline development.Dr. Douketis is a Fellow of the Canadian Academy of Health Science, Associate Editor of McMaster Textbook of Internal Medicine, Editor-in-Chief of Canadian Journal of General Internal Medicine, Deputy Editor of Annals of Internal Medicine ACP Journal Club, and Associate Editor of Thrombosis and Haemostasis. He has over 350 peer-reviewed publications.Related Thrombosis Canada Resources:DOAC Bleeding Management Clinical Guide: [LINK]DOAC Perioperative Management Clinical Guide: [LINK]Perioperative Anticoagulant Algorithm: [LINK]Follow us on Twitter: @thrombosiscanReference:Abraham NS, Barkun AN, Sauer BG, Douketis J, Laine L, Noseworthy PA, Telford JJ, Leontiadis GI. American College of Gastroenterology-Canadian Association of Gastroenterology Clinical Practice Guideline: Management of Anticoagulants and Antiplatelets During Acute Gastrointestinal Bleeding and the Periendoscopic Period. Journal of the Canadian Association of Gastroenterology. 2022 Apr;5(2):100-1Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

The RAPID Trial - a discussion with Dr Michelle Sholzberg

Play Episode Listen Later Jun 3, 2022 24:08 Transcription Available

In this episode have a conversation with Dr Michelle Sholzberg on her recent publication from the British Medical Journal entitled Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial (BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n2400) which was co-authored by an international team on behalf of the RAPID trial investigators.Dr. Sholzberg received her MDCM and residency training in Internal Medicine at McGill University, completed additional postgraduate training in Hematology at the University of Toronto and a research hemostasis fellowship in Toronto and internationally. Dr. Sholzberg has a Master of Science from the University of Toronto in Clinical Epidemiology and Health Care Research and was awarded the Claire Bombardier award for career promise as a scientist. She is a clinician-investigator with a focus on coagulation, the Division Head of Hematology-Oncology and the Medical Director of the Coagulation Laboratory at St. Michael's Hospital. She is also the Director of the Hematology-Oncology Clinical Research Group and Co-director of the Hematology-Immunology Translational Research Theme of the Li Ka Shing Knowledge Institute. Dr. Sholzberg is the associate editor for illustrated materials at Research and Practice in Thrombosis and Haemostasis. Currently, she is involved in the study of: prediction tools for perioperative and traumatic bleeding, the intersection of women's health and bleeding disorders, treatments for iron deficiency anemia, new treatments for immune thrombocytopenia and the management of COVID-19 coagulopathy. Follow us on Twitter:Dr Michelle Sholzberg: @sholzbergThrombosis Canada: @ThrombosisCan Reference:Sholzberg M, Tang GH, Rahhal H, AlHamzah M, Kreuziger LB, Áinle FN, Alomran F, Alayed K, Alsheef M, AlSumait F, Pompilio CE. Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial. BMJ. 2021 Oct 14;375. Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Anti-seizure & Anticoagulant medications & interactions

The BSH Guidelines Official Podcast

Play Episode Listen Later Apr 21, 2022 30:42 Transcription Available

This is Episode 4 of CLOT Conversations from Thrombosis Canada. In this episode Dr Jameel Abdulrehman and David Airdrie are joined by Dr Vinai Bhagirath and Dr Sam Schulman, two of the authors of a recently published paper entitled Carbamazepine, phenytoin, and oral anticoagulants: Drug-drug interaction and clinical events in a retrospective cohort. The paper was published in Research and Practice in Thrombosis and Haemostasis (Res Pract Thromb Haemost. 2022;6:e12650. https://doi.org/10.1002/rth2.12650)The authors discuss the results of the retrospective cohort of patients taking carbamazepine or phenytoin with warfarin or DOACs. In particular, they explore whether there is a relationship between anticoagulant levels and thromboembolic events. Dr Schulman and Dr Bhagirath discuss their perspectives on the issues relevant to each type of anticoagulant when used in patients on anti-seizure medications and what their study added to the understanding of drug-drug interactions.Dr Sam Schulman graduated from Karolinska Institutet, Stockholm, Sweden in 1977 and has worked with coagulation disorders since 1984. Research activities have been clinical studies in venous thromboembolism, in hemophilia and bleeding. He has been a member of the Executive Committee of the World Federation of Hemophilia, was President for the XXV ISTH Congress, Toronto, 2015, is member of the ISTH Council and Treasurer. In 2017 he received Harold R. Roberts medal of the ISTH SSC. He is Director of the Thrombosis Service at Hamilton General Hospital and professor in Medicine at McMaster University, Hamilton, Canada, and at Department of Obstetrics and Gynaecology, The First I.M. Sechenov Moscow State Medical University, Moscow, Russia.Dr Vinai Bhagirath, is a Thrombosis physician at Hamilton Health Sciences and Assistant Professor of Medicine at McMaster University. His research interests include bleeding risk with anticoagulants and clinical measurement of DOAC drug levels. His quality improvement interests include optimization of medical therapy in peripheral artery disease and standardization of periprocedural management of antithrombotic medications. His educational activities include Directorship of Thrombosis Fellowship programs at McMaster, and he is co-chair of the upcoming 2022 THSNA Summit and chair of Thrombosis Canada's Continuing Professional Development committee.Thrombosis Canada Tools related to the content:DOAC Drug Interaction tool: https://thrombosiscanada.ca/wp-uploads/uploads/2021/09/DDI-Tool-Final-English.pdfThrombosis Canada Clinical Guides: https://thrombosiscanada.ca/clinicalguides/Follow us on Twitter: Thrombosis Canada: @ThrombosisCan Sam Schulman: @SamSchulman6Reference: Candeloro, M., Eikelboom, J. W., Chan, N., Bhagirath, V., Douketis, J. D., & Schulman, S. (2022). Carbamazepine, phenytoin, and oral anticoagulants: Drug‐drug interaction and clinical events in a retrospective cohort. Research and Practice in Thrombosis and Haemostasis, 6(2), e12650.Support the showhttps://thrombosiscanada.caTake a look at our healthcare professional and patient resources, videos and publications on thrombosis from the expert members of Thrombosis Canada

Precision Medicine for aTTP: Expert Answers to Your Questions

CCO Oncology Podcast

Play Episode Listen Later Feb 1, 2022 20:00

In this episode, Ara Metjian, MD; Paul Coppo, MD, PhD; and Marshal Mazepa, MD, answer questions from an audience of healthcare professionals on topics related to the management of acquired thrombotic thrombocytopenic purpura (aTTP), including: Rationale of the CAPLAVIE regimen of caplacizumab with corticosteroids and rituximab in aTTP in the acute phaseData for caplacizumab in pediatric patients with aTTPInitiating rituximab after completion of plasma exchangeInternational Society on Thrombosis and Haemostasis guideline recommendations against using aspirinTriggers of aTTP episodes aside from infectionEffect of COVID-19 vaccines and COVID-19 infections on aTTP onset or relapsePresenters:Ara Metjian, MDAssociate ProfessorDivision of HematologyDepartment of MedicineUniversity of Colorado, Anschutz Medical CampusAurora, ColoradoPaul Coppo, MD, PhDProfessor of HematologyHematology Department, AP-HPSorbonne UniversityParis, FranceMarshall Mazepa, MD Assistant Professor of MedicineDivision of Hematology, Oncology, and TransplantationUniversity of MinnesotaMinneapolis, MinnesotaLink to the complete program, including downloadable slidesets, an expert commentary, an on-demand webcast, and healthcare professional resource guide:https://bit.ly/3J1fcad

covid-19 phd colorado md pediatrics oncology precision medicine hematology thrombosis corticosteroids platelets rituximab cd38 haemostasis attp vwf md assistant professor phdprofessor

Episódio 118: Caso Clínico de Sangramento

Ta de Clinicagem

Play Episode Listen Later Dec 8, 2021 53:51

João e Kaue discutem um caso clínico do Pedro, trazendo os principais pontos na abordagem diagnóstico do paciente sangrando. O que é relevante na anamnese? Hereditário ou adquirido? Como interpretar o coagulograma? Tudo isso nesse episódio! Referências: 1. Dilley A, Drews C, Miller C, et al. von Willebrand disease and other inherited bleeding disorders in women with diagnosed menorrhagia. Obstet Gynecol. 2001;97(4):630–636. 2. Knol HM, Mulder AB, Bogchelman DH, Kluin-Nelemans HC, van der Zee AG, Meijer K. The prevalence of underlying bleeding disorders in patients with heavy menstrual bleeding with and without gynecologic abnormalities. Am J Obstet Gynecol. 2013;209(3):202.e1–202.e7. 3. Neutze D, Roque J. Clinical Evaluation of Bleeding and Bruising in Primary Care. Am Fam Physician. 2016;93(4):279-286. 4. Girolami A, Luzzatto G, Varvarikis C, et al. Main clinical manifestations of a bleeding diathesis: an often disregarded aspect of medical and surgical history taking. Haemophilia 2005; 11:193. 5. Schulman S, Kearon C, Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost 2005; 3:692.

definition tudo epis caso scientific refer bleeding international society primary care subcommittee bruising heredit thrombosis anticoagulation haemophilia willebrand kaue haemostasis obstet gynecol am fam physician clinical evaluation am j obstet gynecol

Guidelines for the clinical and laboratory diagnosis of heritable platelet disorders in adults and children

Play Episode Listen Later Aug 27, 2021 12:40

Dr Keith Gomez presents a short podcast on the Guidelines for the clinical and laboratory diagnosis of heritable platelet disorders in adults and children. Dr Gomez discusses the following: 1) Why we need this guideline now 2) Clinical assessment of heritable platelet disorders 3) Laboratory investigations of heritable platelet disorders This guideline replaces the previous British Committee for Standards in Haematology guideline published in 2011 on laboratory diagnosis of heritable disorders of platelet function.1 The remit has been expanded to include clinical diagnosis and heritable thrombocytopenia under the overarching term heritable platelet disorder (HPD). Acquired disorders such as immune thrombocytopenia and drug-induced platelet dysfunction are not covered. Also, Dr Gomez presented this guideline at the BSH ASM Guidelines session and this is available to view. Dr Keith Gomez is the Chair of the BSH Haemostasis and Thrombosis Task Force and the President of the British Society of Haemostasis and Thrombosis. He currently is a Consultant Haematologist and Associate Professor in Haemostasis in the Haemophilia Centre and Thrombosis Unit at the Royal Free Hospital in London.

president children associate professor standards adults disorders diagnosis clinical guidelines gomez laboratory acquired british society thrombosis platelet hpd haematology royal free hospital haemostasis heritable consultant haematologist

#3 Thromboinflammation, rivaroxaban, and extracellular vesicles with Luisa Weiss

Don't Just Read the Guidelines

Play Episode Listen Later Aug 3, 2021 38:24

On this episode, I talk to Luisa Weiss who is a PhD student in Dublin, Ireland. Luisa's has recently published a very interesting paper in the Journal of Thrombosis and Haemostasis entitled: "Nonvalvular atrial fibrillation patients anticoagulated with rivaroxaban compared with warfarin exhibit reduced circulating extracellular vesicles with attenuated pro-inflammatory protein signatures" Here, we talk about the paper, further questions, and the clinical implications of her findings. The paper is available as an open access publication at https://onlinelibrary.wiley.com/doi/10.1111/jth.15434?af=R

phd ireland journal dublin weiss thrombosis extracellular rivaroxaban vesicles haemostasis

Treatment of cancer associated thrombosis: What's the priority for patients?

Vascular Adviser Podcast

Play Episode Listen Later Jul 6, 2021 14:21

In this episode, Dr Mari Thomas and Professor Jan Beyer-Westendorf discuss practical considerations for how physicians should take patient preference into account when deciding on an anticoagulant for the treatment of cancer-associated thrombosis. Further details: • Information on patient persistence with oral anticoagulant treatment compared with parenteral can be found here: https://onlinelibrary.wiley.com/doi/full/10.1002/rth2.12002 • Details on the COSIMO study can be found here: https://thrombosisjournal.biomedcentral.com/articles/10.1186/s12959-018-0176-2 and https://ashpublications.org/blood/article/134/Supplement_1/2161/427953/Baseline-Characteristics-and-Clinical-Outcomes • The American Society of Hematology 2021 guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer guidelines can be found here: https://ashpublications.org/bloodadvances/article-lookup/doi/10.1182/bloodadvances.2020003442 • The American Society of Clinical Oncology venous thromboembolism prophylaxis and treatment in patients with cancer clinical practice guideline update can be found here: https://ascopubs.org/doi/10.1200/JCO.19.01461?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed • The 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer can be found here: https://linkinghub.elsevier.com/retrieve/pii/S1470-2045(19)30336-5 • The International Society on Thrombosis and Haemostasis guidelines on the role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism can be found here: https://doi.org/10.1111/jth.14219 • The 2019 European Society of Cardiology guidelines for the diagnosis and management of acute pulmonary embolism, developed in collaboration with the European Respiratory Society can be found here: https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehz405 Recording approval code: PP-M_RIV-ALL-0195-1; Shownotes approval code: PP-M_RIV-ALL-0196-1

cancer patients treatments priority american society supplement international society cardiology hematology european society clinical oncology thrombosis cosimo z39 jco haemostasis international initiative european respiratory society

Seven days in, seven more to go

Coronacast

Play Episode Listen Later Jun 2, 2021 16:15

The initial seven day lockdown in Melbourne has not been enough to get control of the outbreak in the city.As a result, Melbournians will need to do at least another seven days to give health authorities more time.They've also revealed that the plan is to get the state back to zero spread - or eradication of community spread.So on today's Coronacast, what'll they have to do to get there?Also on today's show:* We've had heaps of questions over the past several weeks on blood clotting from the AstraZeneca vaccine, so we've got Dr Tim Brighton, a haematologist in Sydney and member of Thrombosis and Haemostasis society of Australia and New Zealand in to answer your questions.GUEST:Dr Tim Brighton, haematologist in Sydney, member of THANZ (Thrombosis and Haemostasis society of Australia and New Zealand)

australia new zealand melbourne astrazeneca seven days thrombosis melbournians haemostasis

Seven days in, seven more to go

Coronacast

Play Episode Listen Later Jun 2, 2021 16:15

The initial seven day lockdown in Melbourne has not been enough to get control of the outbreak in the city. As a result, Melbournians will need to do at least another seven days to give health authorities more time. They've also revealed that the plan is to get the state back to zero spread - or eradication of community spread. So on today's Coronacast, what'll they have to do to get there? Also on today's show: * We've had heaps of questions over the past several weeks on blood clotting from the AstraZeneca vaccine, so we've got Dr Tim Brighton, a haematologist in Sydney and member of Thrombosis and Haemostasis society of Australia and New Zealand in to answer your questions. GUEST: Dr Tim Brighton, haematologist in Sydney, member of THANZ (Thrombosis and Haemostasis society of Australia and New Zealand)

australia new zealand melbourne astrazeneca seven days thrombosis melbournians haemostasis

Seven days in, seven more to go

Coronacast

Play Episode Listen Later Jun 2, 2021 16:15

The initial seven day lockdown in Melbourne has not been enough to get control of the outbreak in the city. As a result, Melbournians will need to do at least another seven days to give health authorities more time. They've also revealed that the plan is to get the state back to zero spread - or eradication of community spread. So on today's Coronacast, what'll they have to do to get there? Also on today's show: * We've had heaps of questions over the past several weeks on blood clotting from the AstraZeneca vaccine, so we've got Dr Tim Brighton, a haematologist in Sydney and member of Thrombosis and Haemostasis society of Australia and New Zealand in to answer your questions. GUEST: Dr Tim Brighton, haematologist in Sydney, member of THANZ (Thrombosis and Haemostasis society of Australia and New Zealand)

australia new zealand melbourne astrazeneca seven days thrombosis melbournians haemostasis

BSH ASM: Guidelines Session Question and Answer for Haemostasis and Thrombosis Presentation

The BSH Guidelines Official Podcast

Play Episode Listen Later May 26, 2021 6:52

British Society Haematology Virtual Annual Scientific Meeting Guidelines Session 2021 Haemostasis and Thrombosis Presentations Question and Answer with Keith Gomez and Will Lester; hosted by Jo Howard.

presentation guidelines thrombosis haemostasis jo howard

What is Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT)?

Tom Nikkola Audio Articles

Play Episode Listen Later May 20, 2021 7:21

Good news for those who develop vaccine-induced prothrombotic immune thrombocytopenia after getting the COVID-19 vaccine! You might survive if you get treated soon after symptoms appear. If you've never heard of VIPIT, you're not alone. It's a brand new health condition caused by the new vaccines. VIPIT is one of many different adverse events reported so far. The May 7, 2021 VAERS report contained 192,954 total adverse events, including: 4057 deaths17,190 serious injuries297 miscarriages or premature births1950 cases of Bell's Palsy181 cases of Guillain-Barré Syndrome55,220 cases of anaphylaxis What is Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT)? Vaccine-Induced Prothrombotic Immune Thrombocytopenia seems to be uniquely connected to the Johnson & Johnson and AstraZeneca vaccines. (VIPIT) is characterized by the presence of two conditions concurrently: thrombosis (often in unusual sites like the cerebral sinus veins or splanchnic veins) AND thrombocytopenia.American College of Cardiology To make things a little more confusing, VIPIT is also called Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT) and “thrombotic thrombocytopenic syndrome” (TTS). (In those who develop VIPIT, the vaccine) seems to induce the production of antibodies causing massive activation of platelets via the Fc receptor, resembling heparin-induced thrombocytopenia (HIT), but without previous contact with heparin (HIT mimicry).”Thaler, J, et al. In the case of VIPIT, some of the following symptoms appear four to 28 days after vaccination. This is important because people typically think of adverse events as taking place within 48 hours. That's not the case here. Symptoms of ThrombosisBack painBlood blistersBlurred visionChest or abdominal painDouble visionFocal neurological symptomsMultiple small bruisesPallor and coldness in a limbPersistent and severe headacheReddish or purplish spotsSeizuresShortness of breathSwelling and redness in a limbUnusual bleeding Most VIPIT cases have occurred in otherwise healthy people under 50 who did not have pre-existing health conditions. Rates are higher in women than men as well. If not treated quickly, mortality rates are as high as 50%. Thanks to one patient's medical team, the Journal of Thrombosis and Haemostasis was able to publish a detailed case report of this 62-year-old woman. The complete case report is available here. I've summarized it below. Published Case Study She developed flu-like symptoms the day after vaccination, treated herself, and felt better the day after that. She then took a short trip and cross-country skied for several hours in Austria. On the 5th day, she developed chills, self-medicated, and felt better the next day. On the 8th day, she bit her lip and developed a large hematoma. The next day, she noticed another hematoma on her ankle and that her gums were bleeding. After much testing, the doctors diagnosed her VIPIT. Her treatment included: a fibrinogen concentrateHIT-compatible anticoagulation with short-acting danaparoid-sodiumimmunoglobulinsprednisoloneoral apixaban That's a lot of medication to offset the effects of a vaccine you could argue she didn't need. Read also: How are COVID-19 cases counted? Think for yourself. Don't let a celebrity do it for you. Based on all of the celebrity endorsements, the pleading and incentivizing by Democrat governors, and the shaming by Mainstream Media of those who choose not to get vaccinated, you might believe the vaccine is safe and well-proven. But, unfortunately, that could not be further from the truth. While it is true that the vast majority of people who've gotten one of the vaccines are alive and well today, they're not without risk. In addition, there is no long-term safety data to show they'll be fine long-term. Finally, don't forget that none of these vaccines were available a year ago, and previous mRNA vaccines trialed on animals led to num...

covid-19 vaccines journal democrats austria symptoms rates astrazeneca american colleges mrna immune mainstream media induced tts thaler thrombosis thrombocytopenia haemostasis

Episódio 88: 4 Clinicagens sobre TVP

Ta de Clinicagem

Play Episode Listen Later May 12, 2021 39:34

Rapha, Pedro e Gui discutem quatro clinicagens na Trombose! 1- Quando desconfiar? 2- Quando pode tratar em casa? 3- Quanto tempo eu trato? 4- Tem que investigar trombofilia ou câncer? Minutagem (2:16) Divisão do epsodio (3:13) Quando suspeitar de TVP (5:07) Fatores que dizem a favor de TVP (7:15) O que diminui as chances de ser TVP (8:00) Escore de Wells para TVP (11:58) Quando internar? (14:28) Quem eu vou internar? (16:30) Duração do tratamento (18:20) Baixo risco (19:40) Alto risco (21:43) Risco intermediário (24:38) Quem você pode parar de anticoagular? (27:00) Investigo trombofilias? (30:50) È a investigação do Câncer? (36:00) Salves (38:00) Resposta do desafio da semana anterior (38:35) Desafio da semana! Referências: 1- NICE Guidance Venous Thromboembolism in adults: diagnosis and management https://www.nice.org.uk/guidance/qs29 2- https://www.nice.org.uk/guidance/ng158/evidence/c-investigations-for-cancer-pdf-8710588336 3- ORTEL, Thomas L. et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood advances, v. 4, n. 19, p. 4693-4738, 2020. 4- LIM, Wendy et al. American Society of Hematology 2018 guidelines for management of venous thromboembolism: diagnosis of venous thromboembolism. Blood advances, v. 2, n. 22, p. 3226-3256, 2018. 5- KEARON, C. et al. Categorization of patients as having provoked or unprovoked venous thromboembolism: guidance from the SSC of ISTH. Journal of thrombosis and haemostasis: JTH, v. 14, n. 7, p. 1480-1483, 2016. 6- NICOLAIDES, A. et al. Prevention and treatment of venous thromboembolism: international consensus statement (guidelines according to scientific evidence). Clinical and Applied Thrombosis/Hemostasis, v. 19, n. 2, p. 116-118, 2013. 7- MAZZOLAI, Lucia et al. Diagnosis and management of acute deep vein thrombosis: a joint consensus document from the European Society of Cardiology working groups of aorta and peripheral vascular diseases and pulmonary circulation and right ventricular function. European heart journal, v. 39, n. 47, p. 4208-4218, 2018. 8- CARRIER, Marc et al. Screening for occult cancer in unprovoked venous thromboembolism. New England Journal of Medicine, v. 373, n. 8, p. 697-704, 2015. 9- PICCIOLI, A. et al. Extensive screening for occult malignant disease in idiopathic venous thromboembolism: a prospective randomized clinical trial. Journal of Thrombosis and Haemostasis, v. 2, n. 6, p. 884-889, 2004. 10- ROBERTSON, Lindsay et al. Effect of testing for cancer on cancer‐or venous thromboembolism (VTE)‐related mortality and morbidity in people with unprovoked VTE. Cochrane Database of Systematic Reviews, n. 11, 2018. 11- KONSTANTINIDES, Stavros V. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). European heart journal, v. 41, n. 4, p. 543-603, 2020.

Episode 8 Prof Beverley Hunt OBE - Professor of Thrombosis and Haemostasis - St Thomas' Hospital London

Medspire

Play Episode Listen Later Apr 9, 2021 44:19

Prof Beverley Hunt is a Professor of Thrombosis and Hemostasis at St Thomas' Hospital in London. Some of her key accomplishments include development of national NICE guidelines for thromboembolism (VTE), being one of the co-investigators of CRASH II trial as well setting up her own award winning charity called Thombosis UK. She was awarded an OBE for services to medicine in 2019. In this episode we asked her about her: Career Research interests including COVID Advice for aspiring researchers

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S2E7 - APTT, not a one-for-all-purposes reagent

The BSH Guidelines Official Podcast

Play Episode Listen Later Mar 30, 2021 10:41

Welcome to Ask Stago, the Podcast dedicated to provide expert answers to your expert questions in coagulation. In today episode, our expert Thomas, is covering with us the usages of APTT testing. Literature sources: Toulon, P., Eloit, Y., Smahi, M., Sigaud, C., Jambou, D., Fischer, F. and Appert‐Flory, A. (2016), In vitro sensitivity of different activated partial thromboplastin time reagents to mild clotting factor deficiencies. Int. Jnl. Lab. Hem., 38: 389-396. https://doi.org/10.1111/ijlh.12499 CLSI One-stage Prothrombin Time (PT) test and Activated Partial Thromboplastin Time (APTT) test; Approved guideline - second edition. CLSI document H47-A2 Wayne, PA: Clinical and Laboratory Standard Institute, 2008 Levy JH, Szlam F, Wolberg AS, Winkler A. Clinical use of the activated partial thromboplastin time and prothrombin time for screening: a review of the literature and current guidelines for testing. Clin Lab Med. 2014 Sep;34(3):453-77. doi: 10.1016/j.cll.2014.06.005 Kitchen S, Jennings I, Woods TA, Preston FE. Wide variability in the sensitivity of APTT reagents for monitoring of heparin dosage. J Clin Pathol. 1996 Jan;49(1):10-4. doi: 10.1136/jcp.49.1.10. Gosselin RC, King JH, Janatpour KA, Dager WE, Larkin EC, Owings JT. Comparing direct thrombin inhibitors using aPTT, ecarin clotting times, and thrombin inhibitor management testing. Ann Pharmacother. 2004 Sep;38(9):1383-8. doi: 10.1345/aph.1D565. Gouin-Thibaut I, Martin-Toutain I, Peynaud-Debayle E, et al. Monitoring unfractionated heparin with APTT: a French collaborative study comparing sensitivity to heparin of 15 APTT reagents. Thrombosis Research. 2012 May;129(5):666-667. DOI: 10.1016/j.thromres.2011.11.016. Triplett DA. Screening for the lupus anticoagulant. Ricerca in Clinica E in Laboratorio. 1989; 19-379-89 Denis-Magdelaine A et al; Sensitivity of sixteen APTT reagents for the presence of anticoagulant. Haemostasis 1995; 25:98-105/ Rozen L, Copette F, Noubouossie DF, Demulder A. Evaluation of three APTT reagents in a routine laboratory: toward a compromise. Clin Lab. 2013;59(7-8):921-4. doi: 10.7754/clin.lab.2012.120909 van Rossum, A.P., Vlasveld, L.T., van den Hoven, L.J.M., de Wit, C.W.M. and Castel, A. (2012), False prolongation of the activated partial thromboplastin time (aPTT) in inflammatory patients: interference of C‐reactive protein. Br J Haematol, 157: 394-395. https://doi.org/10.1111/j.1365-2141.2011.08990.x Gu, J.‐M., Ramsey, P., Evans, V., Tang, L., Apeler, H., Leong, L., Murphy, J.E., Laux, V. and Myles, T. (2014), Evaluation of the activated partial thromboplastin time assay for clinical monitoring of PEGylated recombinant factor VIII (BAY 94‐9027) for haemophilia A. Haemophilia, 20: 593-600. https://doi.org/10.1111/hae.12374 Hillarp A, Bowyer A, Ezban M, Persson P, Kitchen S. Measuring FVIII activity of glycopegylated recombinant factor VIII, N8-GP, with commercially available one-stage clotting and chromogenic assay kits: a two-centre study. Haemophilia. 2017 May;23(3):458-465. doi: 10.1111/hae.13168. Ezban M, Hansen M, Kjalke M. An overview of turoctocog alfa pegol (N8-GP; ESPEROCT® ) assay performance: Implications for postadministration monitoring. Haemophilia. 2020;26(1):156-163. doi:10.1111/hae.13897 Related podcasts: Ask Stago S1E11: UFH monitoring: APTT or Anti-Xa? https://www.podcastics.com/podcast/episode/11-%E2%80%93-monitoring-of-ufh-aptt-or-anti-xa-41033/ Ask Stago S1E13: The Lupus Anticoagulant Diagnosis work up: https://www.podcastics.com/podcast/episode/13-the-lupus-anticoagulant-diagnosis-work-up%C2%A0-54015/ ____________________________________________________________________________________________________________ Content is scientific and technical in nature. It is intended as an educational tool for laboratory professionals and topics discussed are not intended as recommendations or as commentary on appropriate clinical practice.

Unpacking von Willebrand disease guidelines: Dr. Paula James talks diagnosis and pre-procedure prophylaxis

Blood & Cancer

Play Episode Listen Later Mar 25, 2021 18:39

Earlier this year, clinical practice guidelines for the diagnosis and management of von Willebrand disease (VWD) were published in Blood Advances. The guidelines (https://bit.ly/2OIfKLE) are a collaborative effort from the American Society of Hematology, the International Society on Thrombosis and Haemostasis, the National Hemophilia Foundation, and the World Federation of Hemophilia. Guideline author Paula James, MD, of Queens University, Kingston, Ont., reviews some of the recommendations in these guidelines with host David H. Henry, MD, in this episode. Case discussion A patient presents with the complaint of heavy menstrual bleeding, which could indicate a bleeding disorder such as VWD. How does one diagnose or rule out VWD? Tests to order include CBC, prothrombin time (PT), and partial thromboplastin time (PTT). Results of CBC, PT, and PTT could be normal, which would necessitate special testing to specifically look at factor VIII and von Willebrand factor (VWF). A patient’s family history may be helpful, as most types of VWD are autosomal dominant, though two subtypes are recessive. Diagnostic evaluation of VWD VWF is the chaperone protein for factor VIII in the intrinsic pathway, which is measured by the PTT. In more severe forms of VWD, the PTT is prolonged because of factor VIII. VWF is measured separately because it is not reflected in the PT or PTT. The recommendation is to measure VWF antigen and employ a functional assay to see how well VWF binds platelets. The recommendation in the new guidelines is to use the GPIbM assay rather than the ristocetin cofactor assay. Many labs in the United States are still using the ristocetin cofactor assay. However, in Canada, Europe, and other parts of the world, many labs have moved to a newer assay that is automated. It has a much lower coefficient of variation and fewer issues with measurement of VWF in Black populations, which is a major issue with the cofactor assay. Types of VWD Type 1 VWD is characterized by a decreased amount of VWF. Type 1 patients have low VWF antigen and low platelet-dependent VWF function to a similar degree, with low or normal factor VIII. Type 2 VWD is characterized by aberrant VWF. The functional assay is a lot lower than VWF antigen. The platelet-dependent function to VWF antigen ratio cutoff is 0.7. Further testing is warranted to determine subtypes (2A, 2B, 2N, or 2M), including VWF multimers. Genetic testing can be helpful to further delineate subtypes. Type 3 VWD is characterized by the absence of VWF. The patient will have a VWF antigen level of 0, platelet-dependent VWF function of 0, and a reduced factor VIII level (usually less than 10%). Pregnant patients with VWD There is a protective adaptation in pregnancy, in which factors normalize in the third trimester, which works to prevent hemorrhage at delivery. This protective effect is because of the hormonal changes of pregnancy, and it is seen in patients with milder forms of VWD. WVF levels peak within 8-24 hours after delivery and then slowly return to baseline. There is a risk of delayed postpartum hemorrhage once VWF levels return to baseline, which tends to happen 7-14 days postpartum. Procedural planning: Desmopressin challenge test Desmopressin causes the release of VWF from the Weibel-Palade bodies of the endothelium, and it can be used as prophylaxis or treatment of bleeding in type 1 VWD. The desmopressin challenge test is used to check how the patient responds to desmopressin when well, to predict the patient’s response after an anticipated procedure. The test involves measuring VWF levels before desmopressin is given and at 1 hour, 2 hours, and 4 hours after desmopressin administration. The idea is to measure the magnitude of increase in VWF levels and observe how sustained that increase is to predict the patient’s response to desmopressin after future procedures. There is a subset of patients with type 1 VWD who have increased clearance of VWF that causes their decreased VWF levels. They may not have a sustained plateau in the VWF level after desmopressin, which emphasizes why testing as far as 4 hours after desmopressin administration is important. The dose of desmopressin given in this test is typically 0.3-0.4 mcg/kg. Recommendations for preprocedure prophylaxis for type 1 VWD Minor procedures (e.g., wisdom tooth extraction) The patient should receive an antifibrinolytic agent, such as tranexamic acid or aminocaproic acid, 2 hours before the procedure, followed by desmopressin 30-60 minutes prior to the procedure. After the procedure, the patient should continue to receive the antifibrinolytic agent for 3-4 days. Major procedures/surgeries (e.g., gallbladder removal) The guidelines do not recommend desmopressin for major procedures because patients need to be fluid-restricted for approximately 24 hours after administration because of the risk of hyponatremia. Desmopressin is a synthetic analog of vasopressin, which results in the accumulation of free water similarly to vasopressin. The guidelines do recommend giving VWF-containing concentrate to increase VWF and factor VIII to greater than 50% from baseline for at least 3 days. VWF concentrates can be given every 12 hours or as continuous intravenous infusions. Tranexamic acid should be given as an adjuvant both prior to the procedure and in the days following. Cryoprecipitate is not recommended because it can’t be virally inactivated. Preprocedure prophylaxis in type 2 or 3 VWD Desmopressin does not work for most patients with type 2 or 3 VWD. So even for minor procedures, these patients will need to receive VWF concentrate coupled with antifibrinolytics. Show notes written by Sheila DeYoung, DO, a resident at Pennsylvania Hospital, Philadelphia. Disclosures Dr. Henry has no relevant disclosures. Dr. James disclosed relationships with Baxter/Baxalta/Shire, CSL Behring, Bayer, and Octapharma. * * * For more MDedge Podcasts, go to mdedge.com/podcasts Email the show: podcasts@mdedge.com Interact with us on Twitter: @MDedgehemonc David Henry on Twitter: @davidhenrymd

united states canada black europe blood philadelphia md types tests recommendations unpacking results ash diagnosis pregnant guidelines viii cbc procedures american society genetic bayer bleeding wfh interact 2m diagnostic international society 2b 2a ont queens university hematology procedural david h world federation hemophilia thrombosis prophylaxis ptt isth pennsylvania hospital csl behring willebrand nhf tranexamic haemostasis von willebrand disease vwd vwf national hemophilia foundation disclosures dr paula james mdedge podcasts

Guideline on Laboratory aspects of assays used in haemostasis and thrombosis

Play Episode Listen Later Feb 22, 2021 35:49

Peter Baker presents a short podcast on the BSH Guideline on Laboratory aspects of assays used in haemostasis and thrombosis. Peter Baker discusses the following: 1) Preanalytical variables 2) Calibration and control of assays including generation reference ranges 3) Assays involved in the investigation of a bleeding and thrombotic tendency 4) TTP and Molecular testing This guideline is intended to help clinical laboratories perform high quality valid assays for basic procoagulants and anticoagulants as part of a routine diagnostic service. Areas that overlap with or have been included in other BSH (https://b‐s‐h.org.uk/guidelines/) or United Kingdom Haemophilia Centre Doctors Organisation (UKHCDO)(http://www.ukhcdo.org/guidelines/) guidelines have been omitted, including guidance on: heparin‐induced thrombocytopaenia (HIT); lupus anticoagulant (LA) testing; D‐dimer assays; platelet function testing; diagnosis of von Willebrand disease (VWD); measurement of factor replacement in haemophilia A and B; monitoring of anticoagulants [vitamin K antagonists (VKA) and direct oral anticoagulants (DOAC)]; and global assays of haemostasis (e.g. TEG, ROTEM, thrombin generation). Peter Baker is a Clinical Scientist working at the department of Haematology at Oxford University Hospitals NHS Trust.

areas guidelines aspects laboratory molecular calibration ttp thrombosis peter baker rotem doac assays teg haematology bsh willebrand haemostasis vwd

#13 The Lupus Anticoagulant diagnosis work up

Play Episode Listen Later Dec 8, 2020 9:59

Welcome to Ask Stago, the weekly podcast dedicated to providing expert answers to your expert questions in coagulation.   This week, with our expert Lisa Gannon, product line manager, Cécile Hourquet and Audrey Carlo will question how to accurately perform an Lupus Anticoagulant diagnosis work up in the laboratory.   Sources: Miyakis S, Lockshin MD, Atsumi T, Branch DW, Brey RL, Cervera R, Derksen RH, De Groot PG, Koike T, Meroni PL, Reber G, Shoenfeld Y, Tincani A, Vlachoyiannopoulos PG, Krilis SA. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306 Devreese KMJ, Ortel TL, Pengo V, de Laat B; Subcommittee on Lupus anticoagulant/Antiphospholipid antibodies. Laboratory criteria for antiphospholipid syndrome: communication from the SSC of the ISTH. J Thromb Haemost 2018; 16: 809-813 CLSI Laboratory testing for the Lupus anticoagulant - Approved Guideline. CLSI document H60-A. Wayne, PA; 2014. Devreese, KMJ, de Groot, PG, de Laat, B, et al. Guidance from the Scientific and Standardization Committee for lupus anticoagulant/antiphospholipid antibodies of the International Society on Thrombosis and Haemostasis. J Thromb Haemost. 2020; 18: 2828– 2839. https://doi.org/10.1111/jth.15047 V. Chantarangkul, F. Peyvandi, A. Tripodi, et al., Effect of different methods for outlier detection and rejection when calculating cut off values for diagnosis of lupus anticoagulants, Thrombosis Research (2018), https://doi.org/10.1016/j.thromres.2020.03.018 CLSI Defining, Establishing and Verifying Reference Intervals in the Clinical Laboratory: Approved guideline Third edition. CLSI document C28-A3- Wayne, PA; 2008

VTE Dublin Podcast 37 | Menno Huisman | Diagnostic Management of Venous Thromboembolism – facts & challenges in 2018

challenges management dublin diagnostic menno huisman venous thromboembolism haemostasis

Play Episode Listen Later Nov 23, 2020 28:15

Welcome back to the VTE Dublin Podcast where you’ll find all the recent talks from the VTE Dublin Conference. Be sure to subscribe to the VTE Dublin Podcast Diagnostic Management of Venous Thromboembolism – facts & challenges in 2018 Prof Menno Huisman | Professor of Haemostasis and Thrombosis | Leiden University | Netherlands Video: https://vimeo.com/471944593 […]

VTE Dublin Podcast 24 | Menno Huisman | Home Treatment of Pulmonary Thromboembolism – are we ready for it?

treatments dublin pulmonary menno huisman thromboembolism haemostasis

Play Episode Listen Later Aug 24, 2020 20:58

Welcome back to the VTE Dublin Podcast where you’ll find all the recent talks from the VTE Dublin Conference. Be sure to subscribe to the VTE Dublin Podcast Home Treatment of Pulmonary Thromboembolism – are we ready for it? Prof Menno Huisman | Professor of Haemostasis and Thrombosis | Leiden University | Netherlands iTunes | […]

Ep 161 - COVID-19 Journal Club #1

The St.Emlyn's Podcast

Play Episode Listen Later Apr 15, 2020 39:53

Professor Rick Body is joined by Prof Paul Klapper (Professor of Clinical Virology), Dr Charlie Reynolds (NIHR Clinical Research Fellow), Prof Pam Vallely (Professor of Medical Virology), Dr Anisa Jafar (Academic Clinical Lecturer) and Prof Simon Carley (you know him...) to discuss six papers about COVID-19 infection. 03:10 - Paper 1 – Guan et al. Clinical characteristics of Coronavirus disease 2019 in China. NEJM Feb 28 2020 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 16:54 Paper 2 – Zou et al. Single Cell RNA-SEQ Data Analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-NCOV infection. Frontiers of Medicine. Mar 12 2020. https://link.springer.com/content/pdf/10.1007/s11684-020-0754-0.pdf 21:43 Paper 3 – Gautret et al. Hydroxychloroquine and azithromycin treatment of COVID-19: Results of an open-label non-randomised clinical trial. International Journal of Antimicrobial Agents. 20 Mar 2020 https://www.sciencedirect.com/science/article/pii/S0924857920300996?via%3Dihub 25:25 Paper 4 – Cao et al. A trial of Lopinavir-Ritonavir in adults hospitalized with severe COVID-19. NEJM Mar 18 2020 https://www.nejm.org/doi/pdf/10.1056/NEJMoa2001282 29:35 Paper 5 – Cui et al. Prevalence of venous thromboembolism in patients with severe Coronavirus pneumonia. Journal of Thrombosis and Haemostasis. Apr 9 2020 doi:10.1111/jth.14830 https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.14830 34:14 Paper 6 – Lynarts et al. Prediction models for diagnosis and prognosis of COVID-19 infection: systematic review and critical appraisal. BMJ. Apr 7 2020 BMJ 2020;369:m1328 https://www.bmj.com/content/bmj/369/bmj.m1328.full.pdf

Episódio 30: 4 Clinicagens do Guideline de TEP ESC 2019

Ta de Clinicagem

Play Episode Listen Later Mar 4, 2020 45:19

Mais um guideline no TdC! Dessa vez discutimos a diretriz de tromboembolismo pulmonar da Sociedade Europeia de Cardiologia (ESC, European Society of Cardiology) que saiu em 2019. Pegamos 4 clinicagens do guideline e destrinchamos nesse episódio! // MINUTAGEM [02:19] Salves [04:03] Dá pra mandar um TEP pra casa? [09:20] E a TC serve para algo além do diagnóstico? [13:51] Anticoagulantes [16:25] Trombólise no TEP [22:50] Posso fazer heparina + trombolítico? [25:15] TEP subsegmentar [32:00] Outras embolias [32:47] Embolia amniótica [35:30] Embolia gordurosa [37:35] Embolia aérea [42:27] Desafio diagnóstico // REFERÊNCIAS: KONSTANTINIDES, Stavros V. et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC). European heart journal, v. 41, n. 4, p. 543-603, 2020. // ZONDAG, W. et al. Outpatient treatment in patients with acute pulmonary embolism: the Hestia Study. Journal of thrombosis and haemostasis, v. 9, n. 8, p. 1500-1507, 2011. // CARRIER, M. et al. Subsegmental pulmonary embolism diagnosed by computed tomography: incidence and clinical implications. A systematic review and meta‐analysis of the management outcome studies. Journal of Thrombosis and Haemostasis, v. 8, n. 8, p. 1716-1722, 2010. // AUJESKY, Drahomir et al. Outpatient versus inpatient treatment for patients with acute pulmonary embolism: an international, open-label, randomised, non-inferiority trial. The Lancet, v. 378, n. 9785, p. 41-48, 2011. // MEYER, Guy et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N engl j med, v. 370, p. 1402-1411, 2014 // Chatterjee S, Chakraborty A, Weinberg I, Kadakia M, Wilensky RL, Sardar P, Kumbhani DJ, Mukherjee D, Jaff MR, Giri J. Thrombolysis for pulmonary embolism and risk of all-cause mortality, major bleeding, and intracranial hemorrhage: a meta-analysis. JAMA 2014;311:24142421.

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S02E02 Haemostasis and Coagulation with Marcel Levi

Haematology Podcast

Play Episode Listen Later Aug 26, 2019 33:36

We are joined in this episode by Prof Marcel Levi, the CEO of University College London Hospitals and a practicing Haematology consultant that specialises in coagulopathies, thrombosis and angioedema. This wide ranging discussion initially covers the skill of balancing clinical and managerial work, and how a medical approach to problem solving can be applied to board meetings. We discuss the clotting cascade, and why coagulation is far simpler than medical text books convey, the treatment of DIC and Vitamin K deficiency and how to understand a clotting screen. Finally we move onto Haemophilia, Angioedema and why Haematology is the best speciality to work in.

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Intracellular Slashed after Mixed Trial $ITCI

Behind The Bid

Play Episode Listen Later Jul 8, 2019 9:37

Check out BehindTheBid.com. Where you can go and get all your premarket information at a glance. Here's the daily Premarket Breakfast https://www.behindthebid.com/posts/premarket-breakfast-for-monday-july-8th/ Four stories for today include Deutsche Bank restructure, more info on Symantec acquisition from Broadcom, data from the International Society on Thrombosis and Haemostasis, and Intracelluar's Phase 3 results for Depression.

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Bleeding gums AKP

Dr Waqar Ali Khokhar

Play Episode Listen Later Mar 26, 2019 36:43

Haemostasis

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VTE Dublin Podcast 13 | Beverly Hunt | Obesity and VTE

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Play Episode Listen Later Jun 11, 2018 21:24

Welcome back to the new VTE Dublin Podcast where you’ll find all the recent talks from the VTE Dublin Conference. Professor Hunt is Professor of Thrombosis & Haemostasis at King’s College, London Be sure to subscribe to the VTE Dublin Podcast iTunes | Android | Stitcher Video: VTE Dublin Podcast 13 | Beverly Hunt | […]

Beverly Hunt | Prevention and management of VTE in pregnancy