scholarly journals The Practicality of Viscoelastic Testing in Acute Hemorrhage to Guide Appropriate Transfusion Management

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
K Weng
Keyword(s):  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Clinical Situation ◽  
Appropriate Use ◽  
Acute Hemorrhage ◽  
Inappropriate Use ◽  
Advantages And Disadvantages ◽  
Coagulation Tests

Abstract Introduction/Objective Acute hemorrhage often leads to multiple blood product transfusions and warrants efficient and dependable laboratory tests to elucidate the etiology for appropriate transfusion management. Conventional coagulation tests (aPPT, PT, INR, platelet count, fibrinogen) are inexpensive and have minimal labor requirements, but have slow turnaround times and may not accurately represent in vivo coagulopathies leading to inappropriate use of transfusion products, which in turn may lead to increased adverse events and mortality. Viscoelastic testing (VET) overcomes some of the disadvantages of conventional coagulation tests, but is not without its own limitations. This case study will summarize the advantages and disadvantages of VET by presenting two cases to highlight clinical situations in which VET is used and its impact on guiding management and clinical outcomes. Methods/Case Report We present 2 cases of acute hemorrhage to illustrate the importance of correct interpretation of VET in the appropriate clinical setting. Case 1 features a clinical situations in which TEG was misinterpreted due to lack of communication with the laboratory while Case 2 presents an acute hemorrhage situation in which Rapid TEG was used to guide transfusion strategy. While VET has many advantages in acute hemorrhage, clinicians must be aware of the disadvantages and the potential for misinterpretation of data. Results (if a Case Study enter NA) NA Conclusion VET is useful in acute hemorrhage if its functionality is understood and interpretation is correct. Appropriate use of VET may lead to effective transfusion management and improve clinical outcomes. However, it is imperative clinicians are aware of the limitations of VET when making clinical decisions. VET can only improve patient outcomes if it is used in the proper clinical situation and with proper interpretation of the data. Appropriate use of VET has the potential to improve transfusion management and ultimately lead to better patient outcomes.

scholarly journals Macrophages in Acute Myeloid Leukaemia: Significant Players in Therapy Resistance and Patient Outcomes

2021 ◽  
Vol 9 ◽  
Author(s):  
Katerina E. Miari ◽  
Monica L. Guzman ◽  
Helen Wheadon ◽  
Mark T. S. Williams
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Clinical Outcomes ◽  
Patient Outcomes ◽  
Therapy Resistance ◽  
Research Field ◽  
Cell Death Pathways ◽  
Leukaemic Cells ◽  
Acute Myeloid

Acute Myeloid Leukaemia (AML) is a commonly occurring severe haematological malignancy, with most patients exhibiting sub-optimal clinical outcomes. Therapy resistance significantly contributes towards failure of traditional and targeted treatments, disease relapse and mortality in AML patients. The mechanisms driving therapy resistance in AML are not fully understood, and approaches to overcome therapy resistance are important for curative therapies. To date, most studies have focused on therapy resistant mechanisms inherent to leukaemic cells (e.g., TP53 mutations), overlooking to some extent, acquired mechanisms of resistance through extrinsic processes. In the bone marrow microenvironment (BMME), leukaemic cells interact with the surrounding bone resident cells, driving acquired therapy resistance in AML. Growing evidence suggests that macrophages, highly plastic immune cells present in the BMME, play a role in the pathophysiology of AML. Leukaemia-supporting macrophage subsets (CD163+CD206+) are elevated in preclinical in vivo models of AML and AML patients. However, the relationship between macrophages and therapy resistance in AML warrants further investigation. In this review, we correlate the potential links between macrophages, the development of therapy resistance, and patient outcomes in AML. We specifically focus on macrophage reprogramming by AML cells, macrophage-driven activation of anti-cell death pathways in AML cells, and the association between macrophage phenotypes and clinical outcomes in AML, including their potential prognostic value. Lastly, we discuss therapeutic targeting of macrophages, as a strategy to circumvent therapy resistance in AML, and discuss how emerging genomic and proteomic-based approaches can be utilised to address existing challenges in this research field.

Linguistic Interactions: A Therapeutic Consideration for Adults With Aphasia

2008 ◽  
Vol 17 (3) ◽  
pp. 93-98
Author(s):  
Lynn E. Fox
Keyword(s):  
Clinical Outcomes ◽  
Social Contexts ◽  
Interaction Models ◽  
Social Communities ◽  
Wernicke's Aphasia ◽  
Communication Challenges ◽  
Therapeutic Consideration ◽  
Patterns Of Interaction ◽  
Structural Language

Abstract Linguistic interaction models suggest that interrelationships arise between structural language components and between structural and pragmatic components when language is used in social contexts. The linguist, David Crystal (1986, 1987), has proposed that these relationships are central, not peripheral, to achieving desired clinical outcomes. For individuals with severe communication challenges, erratic or unpredictable relationships between structural and pragmatic components can result in atypical patterns of interaction between them and members of their social communities, which may create a perception of disablement. This paper presents a case study of a woman with fluent, Wernicke's aphasia that illustrates how attention to patterns of linguistic interaction may enhance AAC intervention for adults with aphasia.

Anticoagulant Properties of Three Mucopolysaccharides Used in Rheumatology

1983 ◽  
Vol 50 (03) ◽  
pp. 652-655 ◽  
Author(s):  
F Bauer ◽  
P Schulz ◽  
G Reber ◽  
C A Bouvier
Keyword(s):  
Factor Xa ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Thrombin Time ◽  
Coagulation Tests ◽  
Amplification System ◽  
Relative Potencies ◽  
In Vivo Administration

SummaryThree mucopolysaccharides (MPS) used in the treatment of degenerative joint disease were compared to heparin to establish their relative potencies on 3 coagulation tests, the aPTT, the antifactor X a activity and the dilute thrombin time. One of the compounds, Arteparon®, was one fourth as potent as heparin on the aPTT, but had little or no influence on the 2 other tests. Further in vitro studies suggested that Arteparon® acted at a higher level than factor Xa generation in the intrinsic amplification system and that its effect was independent of antithrombin III. In vivo administration of Arteparon® confirmed its anticoagulant properties, which raises the question of the clinical use of this MPS.

PERFUSION OF OVARIES IN VITRO AND IN VIVO

1972 ◽  
Vol 68 (2_Supplb) ◽  
pp. S285-S309 ◽  
Author(s):  
Kurt Ahrén ◽  
Per Olof Janson ◽  
Gunnar Selstam
Keyword(s):  
Perfusion System ◽  
Perfusion Technique ◽  
Preliminary Results ◽  
Advantages And Disadvantages

ABSTRACT This paper discusses in vivo and in vitro ovarian perfusion systems described so far in the literature. The interest is not focussed primarily on the results of these studies but rather on the advantages and disadvantages of the techniques and methods used. Another part of the paper summarizes the points which are most important, in our opinion, to take into consideration when developing an in vitro perfusion technique of the ovary. The last part of the paper gives a description of and some preliminary results from an in vitro perfusion system of the rabbit ovary which is under development in this laboratory.

Regime of Fiscal Incorporation (RIF): A Tool That Gives Competitiveness to Start-Ups in Mexico

2018 ◽  
Vol 9 (12) ◽  
pp. 1042-1046
Author(s):  
Tadeo Armando Barrón López ◽  
Keyword(s):  
Latin America ◽  
Income Tax ◽  
Appropriate Use ◽  
Old Regime ◽  
Advantages And Disadvantages ◽  
Start Ups

The following text will show the different tax forms for a newly created company to become competitive, analyze the subsidies they have in a federal tax (Income Tax), compare the tax incorporation regime (RIF) with The old regime of small taxpayers (REPECO), analyzes the advantages and disadvantages of the appropriate use of RIF for start-ups, and finally, the tax incorporation regime is compared with similar ones in Latin America, reflecting on tax contributions Which each government has to raise so that its governments are efficient and effective within a country.

Design process for serious activities inspired by play and games: a problem solving with a board game from disengamement and gamification processes (Preprint)

2020 ◽  
Author(s):  
Stéphane Goria ◽  
Louise Dupet ◽  
Maëva Négroni ◽  
Gabriel Sega ◽  
Philippe Arnoux ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Serious Games ◽  
Diagnostic Method ◽  
Scientific Literature ◽  
Imaging Techniques ◽  
Point Of View ◽  
Board Game ◽  
Advantages And Disadvantages ◽  
Design Result

BACKGROUND most serious games and other game-based tools are designed as digital games or escape games. They are designed for learning or sometimes in the field of medicine as an aid to care. However, they can also be seen as an aid to research, in our case, to evaluate the advantages and disadvantages of imaging techniques for cancer detection. OBJECTIVE we present a case study of action research on the design of a serious board game intended to consider the advantages and weaknesses of a diagnostic method in a different ways. The goal was to better understand the principles of designing a tool using game or play. METHODS we explicitly implemented another process than gamification to develop a structure reminiscent of the game to highlight the strengths and weaknesses of different imaging techniques from the point of view of the respondents (in this case specialists not directly involved in the project). Based on this feedback and the scientific literature on this subject, we detail the main categories of games and games developed for serious use in order to understand their differences. Concerning the cancer research part to which game contributes, our method is based on questions asked to experts and practitioners of this specialty. RESULTS an expert point of view translation tool in the form of a game has been realized to apprehend a research in a different way. CONCLUSIONS we show with the help of a diagram, some possible design paths leading to this type of design result including two hidden dimensions to consider (the awareness of the game or play by the "player" and his role as a contributor or recipient).

Science Fiction and Administrative Truths: The Short Story and Novella as Administrative Cases

Public Voices ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 61
Author(s):  
Nolan J. Argyle ◽  
Lee M. Allen
Keyword(s):  
Science Fiction ◽  
Public Administration ◽  
Short Story ◽  
Interesting Case ◽  
Organizational Complexity ◽  
Professional Career ◽  
Playing Field ◽  
Advantages And Disadvantages ◽  
Hands On

Pre-service and in-service MPA students share a common desire for hands-on, real world instruction related to their professional career goals, leading to a pedagogic discounting of fiction as an appropriate tool for analyzing and "solving" problems. However, several factors weigh heavily in favor of using science fiction short stories and novellas in the MPA classroom setting. These include the need for interesting case scenarios exploring various administrative issues; leveling the playing field between the two types of students by de-emphasizing the use of "contemporary" cases; access to literature that explores the future shock of increasing organizational complexity; and the desirability of Rorschach type materials that facilitate discussion of. values and administrative truths. The discussion proceeds by tracing the development of the case study technique, its advantages and disadvantages in the classroom, addressing the utility of "fiction" as an educational resource, and showing how the science fiction literature has matured to the point where it can be applied in all of the major sub-fields of public administration. Several outstanding examples are detailed, and a thorough bibliography is provided.

Implantable neural interfaces

2018 ◽  
Author(s):  
Stefano Vassanelli
Keyword(s):  
Brain Function ◽  
Large Scale ◽  
Ionic Channels ◽  
Patch Clamp Technique ◽  
Advantages And Disadvantages ◽  
Optogenetic Stimulation ◽  
Physical Interfaces ◽  
The Brain

Establishing direct communication with the brain through physical interfaces is a fundamental strategy to investigate brain function. Starting with the patch-clamp technique in the seventies, neuroscience has moved from detailed characterization of ionic channels to the analysis of single neurons and, more recently, microcircuits in brain neuronal networks. Development of new biohybrid probes with electrodes for recording and stimulating neurons in the living animal is a natural consequence of this trend. The recent introduction of optogenetic stimulation and advanced high-resolution large-scale electrical recording approaches demonstrates this need. Brain implants for real-time neurophysiology are also opening new avenues for neuroprosthetics to restore brain function after injury or in neurological disorders. This chapter provides an overview on existing and emergent neurophysiology technologies with particular focus on those intended to interface neuronal microcircuits in vivo. Chemical, electrical, and optogenetic-based interfaces are presented, with an analysis of advantages and disadvantages of the different technical approaches.

scholarly journals Biomechanics of Neutrophil Tethers

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 515
Author(s):  
Andrea Cugno ◽  
Alex Marki ◽  
Klaus Ley
Keyword(s):  
Cell Activation ◽  
Optical Trap ◽  
Biomechanical Properties ◽  
Force Microscopy ◽  
Advantages And Disadvantages ◽  
Atomic Force ◽  
Microfluidic Flow ◽  
Biomembrane Force Probe ◽  
Membrane Reservoir

Leukocytes, including neutrophils, which are propelled by blood flow, can roll on inflamed endothelium using transient bonds between selectins and their ligands, and integrins and their ligands. When such receptor–ligand bonds last long enough, the leukocyte microvilli become extended and eventually form thin, 20 m long tethers. Tether formation can be observed in blood vessels in vivo and in microfluidic flow chambers. Tethers can also be extracted using micropipette aspiration, biomembrane force probe, optical trap, or atomic force microscopy approaches. Here, we review the biomechanical properties of leukocyte tethers as gleaned from such measurements and discuss the advantages and disadvantages of each approach. We also review and discuss viscoelastic models that describe the dependence of tether formation on time, force, rate of loading, and cell activation. We close by emphasizing the need to combine experimental observations with quantitative models and computer simulations to understand how tether formation is affected by membrane tension, membrane reservoir, and interactions of the membrane with the cytoskeleton.

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