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1.
World J Emerg Surg ; 17(1): 48, 2022 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-36100918

RESUMO

OBJECTIVE: Viscoelastic hemostatic assay (VHA) provides a graphical representation of a clot's lifespan and reflects the real time of coagulation. It has been used to guide trauma resuscitation; however, evidence of the effectiveness of VHAs is still limited. This systematic review aims to summarize the published evidence to evaluate the VHA-guided strategy in resuscitating trauma patients. METHODS: The PubMed, Embase, and Web of Science databases were searched from their inception to December 13, 2021. Randomized controlled trials (RCTs) or observational studies comparing VHA-guided transfusion to controls in resuscitating trauma patients were included in this systematic review. RESULTS: Of the 7743 records screened, ten studies, including two RCTs and eight observational studies, met the inclusion criteria. There was great heterogeneity concerning study design, enrollment criterion, VHA device, VHA-guided strategy, and control strategy. Thrombelastography (TEG) was used as a guiding tool for transfusion in eight studies, and rotational thromboelastometry (ROTEM), and TEG or ROTEM were used in the other two studies. The overall risk of bias assessment was severe or mild in RCTs and was severe or moderate in observational studies. The main outcomes reported from the included studies were blood transfusion (n = 10), mortality (n = 10), hospital length of stay (LOS) (n = 7), intensive care unit LOS (n = 7), and cost (n = 4). The effect of the VHA-guided strategy was not always superior to the control. Most of the studies did not find significant differences in the transfusion amount of red blood cells (n = 7), plasma (n = 5), platelet (n = 7), cryoprecipitate/fibrinogen (n = 7), and mortality (n = 8) between the VHA-guided group and control group. Notable, two RCTs showed that the VHA-guided strategy was superior or equal to the conventional coagulation test-guided strategy in reducing mortality, respectively. CONCLUSION: Although some studies demonstrated VHA-guided strategy probable benefit in reducing the need for blood transfusion and mortality when resuscitating trauma patients, the evidence is still not robust. The quality of evidence was primarily downgraded by the limited number of included studies and great heterogeneity and severe risk of bias in these. Further studies are strongly recommended.


Assuntos
Transtornos da Coagulação Sanguínea , Hemostáticos , Transtornos da Coagulação Sanguínea/terapia , Hemostasia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Ressuscitação , Tromboelastografia
2.
Carbohydr Polym ; 296: 119953, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36087997

RESUMO

Hydrogel tissue adhesives that currently available are often fabricated by mixing two or more polymeric components. Single-component hydrogels afford injectability, strong and reversible adhesion remain a formidable challenge. This research describes the creation of the first single-component hyaluronic acid hydrogel adhesive-based on phenylboronic acid-diol ester linkages. Phenylboronic acid can not only serve as a cross-linker to form hydrogel, but also act as an adhesion site for glycosyl compounds found in biological cell membranes. The rheological and compressive tests for the hydrogel show that it has excellent self-healing properties, good injectability and strong compressive strength. Adhesion tests demonstrated that the hydrogel has significantly greater adhesion strength than commercial fibrin glue. These findings suggest that the rational design of hydrogel precursors facilitates the formation of single-component networks and multiple functionalities. In vivo studies further proved the hydrogel was an ideal bio-adhesive with biocompatibility, absorbed wound exudate and hemostasis, and accelerated wound closure.


Assuntos
Ácido Hialurônico , Hidrogéis , Adesivos , Ésteres , Hemostasia , Hidrogéis/química , Cicatrização
3.
Carbohydr Polym ; 296: 119924, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36088022

RESUMO

The development of shape-memory sponge dressings with functions, such as hemostasis, antibacterial activity, and wound healing, is of great significance in clinical applications. Herein, a novel AuNPs@corn stalk/chitin composite sponge (CCAu) was fabricated by crosslinking the chitin matrix with corn stalk-embedded gold nanoparticles (AuNPs). The addition of AuNPs@corn stalk gave the porous chitin sponge shape-recovery ability with improved softness, porosity, and water absorption. Correspondingly, the composite sponge showed better hemostatic effects than commercial PVF sponges. The photothermal effect of AuNPs endowed the composite sponge with excellent antibacterial activity. In addition, the wound treated with composite sponge containing antioxidant AuNPs exhibited a significantly faster wound healing rate (reaching 41.6 % on day 3) than the CH (33.2 %) and control (12.6 %) group through promoting cell migration, angiogenesis and collagen deposition. Therefore, the multifunctional composite sponge with great biocompatibility in this work provides a potential strategy for wound healing.


Assuntos
Hemostáticos , Nanopartículas Metálicas , Antibacterianos/farmacologia , Bandagens/microbiologia , Quitina/farmacologia , Ouro/farmacologia , Hemostasia , Hemostáticos/farmacologia , Cicatrização , Zea mays
4.
Vet Clin North Am Exot Anim Pract ; 25(3): 597-612, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36122942

RESUMO

Whole blood viscoelastic coagulation testing (VCT) allows global assessment of hemostasis and fibrinolysis. Although not widely used in exotic animal practice, VCT has been used in exotic animal research settings. Differences in patient demographics and analytical variables can result in dramatically different results with the same analyzer. To improve the utility of VCT in exotic animal medicine, standardization of protocols is necessary to facilitate the establishment of reference intervals. Despite these challenges, the quantitative/qualitative nature of VCT has already proved its real-world value to some clinicians.


Assuntos
Animais Exóticos , Animais , Testes de Coagulação Sanguínea/métodos , Testes de Coagulação Sanguínea/veterinária , Hemostasia
5.
Vet Clin North Am Exot Anim Pract ; 25(3): 613-630, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36122943

RESUMO

The mammalian hemostatic system is highly conserved, and companion exotic mammals are commonly used as biomedical models for normal and disordered hemostasis. Challenges associated with sample collection, test validation, and test interpretation have limited the use of these tests in clinical exotic animal practice. However, evaluation of platelet counts, coagulation screening times, and fibrin(ogen) degradation products can be valuable for monitoring exotic patients with a range of disease presentations including intoxications, anemia, systemic viral disease, hepatopathy, and endocrinopathy.


Assuntos
Hemostáticos , Animais , Produtos de Degradação da Fibrina e do Fibrinogênio , Hemostasia , Mamíferos , Contagem de Plaquetas/veterinária
6.
Int J Lab Hematol ; 44 Suppl 1: 71-78, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36074714

RESUMO

On May 26th 2017 the European Parliament and the Council of The European Union adopted the new regulation on in vitro diagnostic medical devices (IVDR)-Regulation EU 2017/746-planned to be applied from May 26th 2022 in substitution to the previous IVD directives (IVDD 98/79 EC). After several health and legal causes due to medical device malfunctions, the European Union (EU) extensively reviewed the previous regulatory, which had remained unchanged since 1998. Aim of the work is to analyse the effects of the new IVDR on the field of haemostasis and thrombosis testing with particular attention to specific clinical conditions. Clinical laboratories will mainly deal with three different situations: (1) Diagnostic test performed with IVDR products used according with clinical indication certified by manufacturers. (2) Diagnostic test performed with certified IVDR products without clinical validation. (3) Diagnostic test performed with reagents classified as Research Use Only (RUO). At present, only few clinical laboratories through different European countries have been prepared to the new IVDR, while many laboratories are not yet aware about crucial aspects of the new process that deeply involves laboratory medicine. In conclusion, each laboratory should be aware of the IVDR certification of the reagents/instruments used in its laboratory. There are several urgent needs regarding IVDR certification: studies about the clinical performance of haemostasis tests, guidelines for LDTs (definition and documentation), internal and external quality controls for the tests recommended/suggested in the guidance/guidelines and finally implementation and/or update of clinical and laboratory guidelines.


Assuntos
Acreditação , Laboratórios , União Europeia , Hemostasia , Humanos , Kit de Reagentes para Diagnóstico
7.
Dis Markers ; 2022: 2993309, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36082237

RESUMO

Background: Dyslipidemias are associated with atherosclerotic plaque formation and a prothrombotic state, thus increasing the risk of both atherosclerotic vascular disease and atherothrombotic adverse events. We sought to explore the association between lipoprotein subfractions, overall hemostasis, and coronary calcifications in individuals at intermediate cardiovascular risk. Methods: Consecutive statin-naive individuals at intermediate cardiovascular risk referred for coronary artery calcium score (CACS) scanning were included. CACS was assessed using a 128-slice dual-source CT scanner. Traditional lipid profile, high-density lipoprotein (HDL) subfractions 2 and 3, and small dense low-density lipoproteins (sdLDL) were measured with commercially available assays. Overall hemostatic (OHP) and coagulation potentials (OCP) were measured spectrophotometrically, using fibrin aggregation curves after exposure to thrombin and recombinant tissue-type plasminogen activator, respectively. Overall fibrinolytic potential (OFP) was calculated as a difference between the two areas under curves. Results: We included 160 patients (median age 63 (interquartile range (IQR), 56-71 years, 52% women, and median CACS 8, IQR 0-173 Agatston units). HDL3 levels-but not sdLDL or hemostatic potentials-were significantly associated with CACS zero, even after adjusting for age, sex, arterial hypertension, dyslipidemia, diabetes, and smoking history (OR 0.980 (0.962-0.999), p = 0.034). HDL3 was also significantly associated with OCP (r = -0.232, p adjusted for age and sex 0.037). Conclusions: In patients at intermediate cardiovascular risk, HDL3 is associated with both subclinical atherosclerosis and overall coagulation. Our findings are in line with studies reporting on an inverse relationship between HDL3 and atherosclerosis and provide one possible mechanistic explanation for the association between novel lipid biomarkers and coagulation derangements.


Assuntos
Aterosclerose , Doença da Artéria Coronariana , Dislipidemias , Hemostáticos , Feminino , Hemostasia , Humanos , Lipoproteínas , Lipoproteínas LDL , Masculino , Pessoa de Meia-Idade , Fatores de Risco
8.
Nat Commun ; 13(1): 5035, 2022 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-36028516

RESUMO

Non-compressible hemorrhage is an unmet clinical challenge that accounts for high mortality in trauma. Rapid pressurized blood flows under hemorrhage impair the function and integrity of hemostatic agents and the adhesion of bioadhesive sealants. Here, we report the design and performance of bioinspired microstructured bioadhesives, formed with a macroporous tough xerogel infused with functional liquids. The xerogel can rapidly absorb interfacial fluids such as whole blood and promote blood clotting, while the infused liquids facilitate interfacial bonding, sealing, and antibacterial function. Their synergy enables the bioadhesives to form tough adhesion on ex vivo human and porcine tissues and diverse engineered surfaces without the need for compression, as well as on-demand instant removal and storage stability. We demonstrate a significantly improved hemostatic efficacy and biocompatibility in rats and pigs compared to non-structured counterparts and commercial products. This work opens new avenues for the development of bioadhesives and hemostatic sealants.


Assuntos
Hemostáticos , Adesivos Teciduais , Animais , Materiais Biocompatíveis , Hemorragia , Hemostasia , Humanos , Ratos , Suínos
9.
Colloids Surf B Biointerfaces ; 218: 112742, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35930985

RESUMO

Traditional dressings, such as bandages, gauze, and cotton pads stick to new granulation tissue, thereby aggravating wound injury or causing secondary injury during replacement. Microspheres that are biodegradable and adaptable to various wound shapes are a good alternative to traditional dressings. In this work, a novel microsphere was prepared by reverse microemulsion method using sodium alginate and silk peptide (SP) as the aqueous phase. After cross-linking by Ca2+, calcium alginate (CA) and SP composite microspheres called CA/SP were prepared. By adjusting the SP content, the swelling rate of microspheres reached 1050 % and the pore diameter reached 19.59 nm. In addition, the introducing SP provided a stable loading site for thrombin (Th). This platform (called CA/SP@Th)-integrating rapid blood enrichment, calcium release, and Th catalysis-can ensure rapid hemostasis in a variety of bleeding models. Additionally, the SP present in this modality also promoted fibroblast proliferation, this increased the wound closure rate in a total cortex injury mouse model (more than 97 % within 15 days). Therefore, CA/SP@Th can be used as a multifunctional dressing for rapid hemostasis and wound healing.


Assuntos
Cálcio , Trombina , Alginatos/química , Animais , Hemostasia , Camundongos , Microesferas , Seda , Cicatrização
10.
Cells ; 11(16)2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-36010639

RESUMO

Despite fully functional primary hemostasis, platelets of healthy neonates exhibit hypoaggregability and secretion defects, which may be adaptations to specific requirements in this developmental stage. The etiologies for reduced signal transduction vary with the type of agonist. The discovered peculiarities are lower receptor densities, reduced calcium mobilization, and functional impairments of G proteins. Reduced secretion of dense granules has been attributed to lower numbers of granules. Signaling studies with adult platelets have shown a regulating effect of the G12/13 signaling pathway on dense granule secretion via RhoA. We comparatively analyzed secretion profiles using flow cytometry and expression levels of Gq, Gi, and G12/13 using Western blot analysis in platelets from cord blood and adults. Furthermore, we evaluated Rho activation after in vitro platelet stimulation with thrombin using a pulldown assay. We observed a markedly reduced expression of the dense granule marker CD63 on neonatal platelets after thrombin stimulation. Gα12/13 expression was significantly decreased in neonatal platelets and correlated with lower Rho activation after thrombin stimulation. We conclude that lower expression of G12/13 in neonatal platelets results in attenuated activation of Rho and may contribute to reduced secretion of dense granules after exposure to thrombin.


Assuntos
Plaquetas , Subunidades alfa G12-G13 de Proteínas de Ligação ao GTP/metabolismo , Trombina , Plaquetas/metabolismo , Proteínas de Ligação ao GTP/metabolismo , Hemostasia , Humanos , Recém-Nascido , Transdução de Sinais , Trombina/farmacologia
11.
Food Funct ; 13(18): 9622-9634, 2022 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-36004684

RESUMO

Rapid hemostasis, antibacterial effect and promotion of wound healing are the most important functions that wound dressings need to have. In this work, we designed and prepared a hydrogel with antibacterial effect, hemostatic ability and wound healing promotion using agar, polyvinyl alcohol (PVA) and tannic acid (TA). We performed a series of tests to characterize the structure and properties of AGAR@PVA-TA hydrogels. The results showed that the AGAR@PVA-TA hydrogels had good mechanical properties and excellent antibacterial ability as well as good hemocompatibility. The cytotoxicity results showed that the AGAR@PVA-TA hydrogels had good cytocompatibility. And the TA loaded hydrogels also presented some good performances in animal studies. In the liver hemostasis model, the AGAR@PVA-TA hydrogel showed good hemostatic ability. Also, the AGAR@PVA-TA hydrogel was able to promote wound healing in an S. aureus-infected rat wound model. More importantly, our research results demonstrated that compared to other polyphenols (such as proanthocyanidins), TA could better improve the mechanical properties, antibacterial ability and rapid hemostasis of hydrogels, which illustrated the uniqueness of TA. Therefore, the TA loaded hydrogel (AGAR@PVA-TA hydrogel) has the potential to be applied as a wound dressing.


Assuntos
Hemostáticos , Proantocianidinas , Ágar , Animais , Antibacterianos/química , Antibacterianos/farmacologia , Bandagens , Hemostasia , Hemostáticos/farmacologia , Hidrogéis/química , Polifenóis/farmacologia , Álcool de Polivinil/química , Proantocianidinas/farmacologia , Ratos , Staphylococcus aureus , Taninos/farmacologia
12.
Orv Hetil ; 163(32): 1254-1260, 2022 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-35933620

RESUMO

It is well known that platelets play a major role in hemostasis and thrombosis. Beyond these classic functions, the controlled activation of platelets is required in reproduction and immune response. In this review, we attempt to summarize the most important roles of thrombocytes in reproduction. The most recent studies of thrombocyte research provide remarkable insights into the physiological and clinical importance of this cellular fragment. We have summarized the key findings we have taken from the relevant literature - including our previous publications - and emphasized their significance. The platelet-activating factor and the controlled activation of platelets have important role in folliculogenesis, ovulation, placental development, implantation and embryo development. Activated platelets are involved in the pathogenesis of ovarian hyperstimulation syndrome (OHSS) and preeclampsia. Low-dose aspirin can prevent OHSS during ovulation induction, while intrauterine infusion of platelet-rich plasma (PRP) increases the endometrium thickness and receptivity. Activated platelets rapidly release the contents of preformed intracellular granules and have multiple adhesion molecules and receptors on their surface. Considering the numerous homeostatic endocrine functions of platelets, it is reasonable to suppose a platelet-associated regulatory system (PARS) in reproduction. Several studies prove the importance of thrombocytes in various essential physiological processes including reproduction. Although we are far from the complete understanding of the regulatory processes, the results of PARS research and the therapeutic application of aspirin and PRP during in vitro fertilisation are promising. Orv Hetil. 2022; 163(32): 1254-1260.


Assuntos
Síndrome de Hiperestimulação Ovariana , Trombose , Aspirina , Plaquetas , Feminino , Hemostasia , Humanos , Placenta , Gravidez
13.
Metabolomics ; 18(8): 65, 2022 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922643

RESUMO

INTRODUCTION: Bipolar disorder (BD) is a mood disorder characterized by the occurrence of depressive episodes alternating with episodes of elevated mood (known as mania). There is also an increased risk of other medical comorbidities. OBJECTIVES: This work uses a systems biology approach to compare BD treated patients with healthy controls (HCs), integrating proteomics and metabolomics data using partial correlation analysis in order to observe the interactions between altered proteins and metabolites, as well as proposing a potential metabolic signature panel for the disease. METHODS: Data integration between proteomics and metabolomics was performed using GC-MS data and label-free proteomics from the same individuals (N = 13; 5 BD, 8 HC) using generalized canonical correlation analysis and partial correlation analysis, and then building a correlation network between metabolites and proteins. Ridge-logistic regression models were developed to stratify between BD and HC groups using an extended metabolomics dataset (N = 28; 14 BD, 14 HC), applying a recursive feature elimination for the optimal selection of the metabolites. RESULTS: Network analysis demonstrated links between proteins and metabolites, pointing to possible alterations in hemostasis of BD patients. Ridge-logistic regression model indicated a molecular signature comprising 9 metabolites, with an area under the receiver operating characteristic curve (AUROC) of 0.833 (95% CI 0.817-0.914). CONCLUSION: From our results, we conclude that several metabolic processes are related to BD, which can be considered as a multi-system disorder. We also demonstrate the feasibility of partial correlation analysis for integration of proteomics and metabolomics data in a case-control study setting.


Assuntos
Transtorno Bipolar , Metabolômica , Estudos de Casos e Controles , Hemostasia , Humanos , Metabolômica/métodos , Proteômica
14.
Int J Mol Sci ; 23(15)2022 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-35955499

RESUMO

Both invertebrates and vertebrates possess a cluster of immediate and local wound-sealing, pathogen-killing, and tissue healing responses known as immunoclotting and immunothrombosis, respectively, to cope with two life-threatening emergencies, namely, bleeding and microbial invasion. Despite their convergence in function, immunoclotting and immunothrombosis are deployed by different blood cells and intravascular multidomain proteins. In vertebrates, these proteins share some domains with intrinsic chemical affinities useful in generating cooperative networks such as pathogen and damage pattern recognition molecules. Moreover, many of the proteins involved in coagulation and fibrinolysis in humans are multifunctional molecules playing roles in other processes from inflammation to healing and beyond. In our modern society, however, the interaction of activated intravascular allosteric proteins with one another and with blood cells entails vulnerabilities posing a biological paradox: intravascular proteins that locally operate as tissue repair enhancers can nevertheless generate pathogenic processes by acting systemically. In this manuscript, we contextualize and frame the coagulation system and hemostasis through an evolutionary time scale, illustrating their role as dual players in the defense against exsanguination and pathogens while significantly influencing wound healing.


Assuntos
Hemostasia , Tromboinflamação , Animais , Coagulação Sanguínea/fisiologia , Fibrinólise/fisiologia , Humanos , Cicatrização
15.
Int J Mol Sci ; 23(15)2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35955928

RESUMO

Serotonin (5-hydroxytriptamine or 5-HT) is known to be a weak platelet agonist, and is involved in thrombus formation. While 5-HT cannot induce platelet aggregation on its own, when secreted from the alpha granules, it binds to its G-protein Coupled Receptor (GPCR; i.e., 5HT2AR), thereby acting to amplify platelet functional responses (e.g., aggregation). Thus, 5HT2AR-mediated responses are more involved in the secondary amplification of platelet aggregation in the growing thrombus. Therefore, even though 5-HT can be seen as a weak inducer of platelet activation, it is an important amplifier of aggregation triggered by agonists such as ADP, collagen, and epinephrine, thereby enhancing thrombogenesis. The 5HT2AR/5HT2A signaling pathway is of clinical interest to the scientific and medical communities as it has been implicated in the genesis of several forms of cardiovascular disorders. However, efforts to develop antagonists for 5HT2AR as therapeutic agents in cardiovascular diseases have thus far failed due to these reagents having deleterious side-effects, and/or to lack of selectivity, amongst other reasons. In light of research efforts that identified that the 5HT2AR ligand binding domain resides in the second extracellular loop (EL2; amino acids P209-N233), we developed an antibody, i.e., referred to as 5HT2ARAb, against the EL2 region, and characterized its pharmacological activity in the context of platelets. Thus, we utilized platelets from healthy human donors, as well as C57BL/6J mice (10-12 weeks old) to analyze the inhibitory effects of the 5HT2ARAb on platelet activation in vitro, ex vivo, and on thrombogenesis in vivo as well as on 5HT2AR ligand binding. Our results indicate that the 5HT2ARAb inhibits 5-HT-enhanced platelet activation in vitro and ex vivo, but has no apparent effects on that which is agonist-induced. The 5HT2ARAb was also found to prolong the thrombus occlusion time, and it did so without modulating the tail bleeding time, in mice unlike the P2Y12 antagonist clopidogrel and the 5HT2AR antagonist ketanserin. Moreover, it was found that the 5HT2ARAb does so by directly antagonizing the platelet 5HT2AR. Our findings document that the custom-made 5HT2ARAb exhibits platelet function blocking activity and protects against thrombogenesis without impairing normal hemostasis.


Assuntos
Serotonina , Trombose , Animais , Anticorpos/metabolismo , Plaquetas/metabolismo , Hemostasia , Humanos , Ligantes , Camundongos , Camundongos Endogâmicos C57BL , Agregação Plaquetária , Inibidores da Agregação Plaquetária/uso terapêutico , Receptor 5-HT2A de Serotonina/metabolismo , Serotonina/metabolismo , Serotonina/farmacologia , Trombose/tratamento farmacológico , Trombose/metabolismo
16.
BMC Ophthalmol ; 22(1): 336, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941541

RESUMO

BACKGROUND: Severe intraocular hemorrhage is a rare complication of cataract surgery due to the recent generalization of minimal-incision cataract surgery. We report a case of a massive intraocular hemorrhage that probably originated from the central retinal artery after cataract surgery, in which hemostasis was difficult to achieve during vitrectomy. CASE PRESENTATION: An 86-year-old woman was referred to our department for intraocular lens (IOL) dislocation after undergoing cataract surgery. Massive intraocular hemorrhage was observed during the initial visit to our department. She underwent pars plana vitrectomy (PPV) and IOL repositioning under local anesthesia. However, the hemorrhage could not be removed completely because of continued massive intraoperative bleeding from the posterior fundus, and it was extremely difficult to achieve hemostasis during the initial surgery. At 7 days after the initial surgery, PPVs were performed under general anesthesia. Bleeding significantly decreased in the second surgery compared to the first. The bleeding probably originated from the central retinal artery on the optic disc; hemostasis was obtained by coagulation of the bleeding site with intraocular diathermy. After the second surgery, there was no exacerbation of bleeding and the patient's condition was stable. However, the patient's visual acuity showed no light perception after the second surgery. CONCLUSIONS: Massive intraocular hemorrhage may occur from the central retinal artery after undergoing cataract surgery. In such cases, surgery with general anesthesia with a lower maintained blood pressure (instead of surgery under local anesthesia) should be recommended, considering the possibility of difficult hemostasis in the event of bleeding from the retinal artery.


Assuntos
Extração de Catarata , Catarata , Oftalmopatias , Hemorragia Ocular , Lentes Intraoculares , Artéria Retiniana , Idoso de 80 Anos ou mais , Catarata/complicações , Extração de Catarata/efeitos adversos , Oftalmopatias/complicações , Hemorragia Ocular/cirurgia , Feminino , Hemostasia , Humanos , Implante de Lente Intraocular/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Vitrectomia/efeitos adversos
17.
Colloids Surf B Biointerfaces ; 218: 112770, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35988313

RESUMO

Uncontrolled bleeding leads to a higher fatality rate in the situation of surgery, traffic accidents and warfare. Traditional hemostatic materials such as bandages are not ideal for uncontrolled or incompressible bleeding. Therefore, it is of great significance to develop a new medical biomaterial with excellent rapid hemostatic effect. Keratin is a natural, biocompatible and biodegradable protein which contains amino acid sequences that induce cell adhesion. As a potential biomedical material, keratin has been developed and paid attention in tissue engineering fields such as promoting wound healing and nerve repair. Herein, a keratin/chitosan (K/C) sponge was prepared to achieve rapid hemostasis. The characterizations of K/C sponge were investigated, including SEM, TGA, liquid absorption and porosity, showing that the high porosity up to 90.12 ± 2.17 % resulted in an excellent blood absorption. The cytotoxicity test and implantation experiment proved that the K/C sponge was biocompatible and biodegradable. Moreover, the prepared K/C sponge showed better hemostatic performance than chitosan sponge (CS) and the commercially available gelatin sponge in both rat tail amputation and liver trauma bleeding models. Further experiments showed that K/C sponge plays a hemostatic role through the endogenous coagulation pathway, thus shortening the activated partial thromboplastin time (APTT) effectively. Therefore, this study provided a K/C sponge which can be served as a promising biomedical hemostatic material.


Assuntos
Quitosana , Hemostáticos , Animais , Bandagens , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Quitosana/química , Quitosana/farmacologia , Gelatina/farmacologia , Hemorragia/tratamento farmacológico , Hemostasia , Hemostáticos/química , Hemostáticos/farmacologia , Queratinas/farmacologia , Ratos
18.
PLoS One ; 17(8): e0273312, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36037218

RESUMO

The stress distribution along the trajectories of passive particles released in turbulent flow were computed with the use of Lagrangian methods and direct numerical simulations. The flow fields selected were transitional Poiseuille-Couette flow situations found in ventricular assist devices and turbulent flows at conditions found in blood pumps. The passive particle properties were selected to represent molecules of the von Willebrand factor (vWF) protein. Damage to the vWF molecule can cause disease, most often related to hemostasis. The hydrodynamic shear stresses along the trajectories of the particles were calculated and the changes in the distribution of stresses were determined for proteins released in different locations in the flow field and as a function of exposure time. The stress distributions indicated that even when the average applied stress was within a safe operating regime, the proteins spent part of their trajectories in flow areas of damaging stress. Further examination showed that the history of the distribution of stresses applied on the vWF molecules, rather than the average, should be used to evaluate hydrodynamically-induced damage.


Assuntos
Coração Auxiliar , Fator de von Willebrand , Hemostasia , Hidrodinâmica , Estresse Mecânico , Fator de von Willebrand/metabolismo
19.
ACS Biomater Sci Eng ; 8(9): 3856-3870, 2022 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-35969223

RESUMO

Millions of people around the globe are affected by full-thickness skin injuries. A delay in the healing of such injuries can lead to the formation of chronic wounds, posing several clinical and economic challenges. Current strategies for wound care aim for skin regeneration and not merely skin repair or faster wound closure. The present study aimed to develop a bioactive wound-healing matrix comprising natural biomaterial silk fibroin (SF), clinical-grade human fibrin (FIB), and human hyaluronic acid (HA), resulting in SFFIBHA for regeneration of full-thickness burn wounds. A porous, hemostatic, self-adhesive, moisture-retentive, and biomimetic scaffold that promotes healing was the expected outcome. The study validated a terminal sterilization method, suggesting the stability and translational potential of the novel scaffold. Also, the study demonstrated the regenerative abilities of scaffolds using in vitro cell culture experiments and in vivo full-thickness burn wounds of critical size (4 cm × 4 cm) in a rabbit model. Under in vitro conditions, the scaffold enhanced primary dermal fibroblast adhesion and cell proliferation with regulated extracellular matrix (ECM) synthesis. In vivo, the scaffolds promoted healing with mature epithelium coverage involving intact basal cells, superficial keratinocytes, multilayers of keratohyalin, dermal regeneration with angiogenesis, and deposition of remodeled ECM in 28 days. The relative gene expression of the IL6 marker indicated transitions from inflammation to proliferation stage. In addition, we observed skin appendages and rete peg development in the SFFIBHA-treated wound tissues. Although wound closure was observed, neither negative (untreated/sham) nor positive (commercially available product; NeuSkin) control wounds developed skin appendages/rete pegs or native skin architecture. After 56 days, healing with organized ECM production enabled the recovery of mechanical properties of skin with higher tissue maturity in SFFIBHA-treated wounds. Thus, in a single application, the SFFIBHA scaffold proved to be an efficient biomimetic matrix that can guide burn wound regeneration. The developed matrix is a suture-less, hemostatic, off-the-shelf product for potential wound regenerative applications.


Assuntos
Queimaduras , Fibroínas , Hemostáticos , Animais , Queimaduras/terapia , Fibroínas/farmacologia , Hemostasia , Temperatura Alta , Humanos , Coelhos , Cicatrização
20.
Carbohydr Polym ; 295: 119868, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-35989011

RESUMO

Effective bleeding control and wound protecting from infection play critical roles in the tissue healing process. However, local hemostats are not involved in the whole healing processes to promote the final healing efficiency. Here, a multi-functional mussel-inspired polysaccharide-based sponge with hemostatic, antibacterial and adhesive properties was fabricated via cryopolymerization of oxidized dextran (OD), carboxymethyl chitosan (CC) and polydopamine nanoparticles (PDA-NPs), followed by lyophilization. Combining with the adsorbed thrombin, the sponges yielded a considerably lower amount of blood than the commercially available hemostatic dressings. Benefiting from the high photo-thermal transition efficiency of PDA-NPs, the sponges exhibited excellent antibacterial activity to both gram positive and negative bacteria. Owing to the rapid hemostatic activity and effective infection resistance, the sponges illustrated the significantly acceleratory wound healing efficiency compared with the control group. The thrombin-loaded OD/CC-PDA polysaccharide-based sponge has great potential for future clinical use as wound dressing.


Assuntos
Quitosana , Hemostáticos , Infecção dos Ferimentos , Animais , Antibacterianos/farmacologia , Bactérias , Bivalves , Quitosana/farmacologia , Hemostasia , Hemostáticos/farmacologia , Humanos , Polissacarídeos/farmacologia , Polissacarídeos/uso terapêutico , Trombina , Cicatrização
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