bleeding rate
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PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262273
Author(s):  
Carolina J. Delgado-Flores ◽  
David García-Gomero ◽  
Stefany Salvador-Salvador ◽  
José Montes-Alvis ◽  
Celina Herrera-Cunti ◽  
...  

Background Different prophylactic and episodic clotting factor treatments are used in the management of hemophilia. A summarize of the evidence is needed inform decision-making. Objective To compare the effects of factor replacement therapies in patients with hemophilia. Methods We performed a systematic search in PubMed, Central Cochrane Library, and Scopus. We included randomized controlled trials (RCTs) published up to December 2020, which compared different factor replacement therapies in patients with hemophilia. Random-effects meta-analyses were performed whenever possible. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The study protocol was registered in PROSPERO (CRD42021225857). Results Nine RCTs were included in this review, of which six compared episodic with prophylactic treatment, all of them performed in patients with hemophilia A. Pooled results showed that, compared to the episodic treatment group, the annualized bleeding rate was lower in the low-dose prophylactic group (ratio of means [RM]: 0.27, 95% CI: 0.17 to 0.43), intermediate-dose prophylactic group (RM: 0.15, 95% CI: 0.07 to 0.36), and high-dose prophylactic group (RM: 0.07, 95% CI: 0.04 to 0.13). With significant difference between these subgroups (p = 0.003, I2 = 82.9%). In addition, compared to the episodic treatment group, the annualized joint bleeding rate was lower in the low-dose prophylactic group (RM: 0.17, 95% CI: 0.06 to 0.43), intermediate-dose prophylactic group (RM of 0.14, 95% CI: 0.07 to 0.27), and high-dose prophylactic group (RM of 0.08, 95% CI: 0.04 to 0.16). Without significant subgroup differences. The certainty of the evidence was very low for all outcomes according to GRADE methodology. The other studies compared different types of clotting factor concentrates (CFCs), assessed pharmacokinetic prophylaxis, or compared different frequencies of medication administration. Conclusions Our results suggest that prophylactic treatment (at either low, intermediate, or high doses) is superior to episodic treatment for bleeding prevention. In patients with hemophilia A, the bleeding rate seems to have a dose-response effect. However, no study compared different doses of prophylactic treatment, and all results had a very low certainty of the evidence. Thus, future studies are needed to confirm these results and inform decision making.


2022 ◽  
Vol 11 (2) ◽  
pp. 352
Author(s):  
Marcin Protasiewicz ◽  
Konrad Reszka ◽  
Wojciech Kosowski ◽  
Barbara Adamik ◽  
Wojciech Bombala ◽  
...  

The coronavirus disease 2019 (COVID-19) shows high incidence of thromboembolic events in humans. In the present study, we aimed to evaluate if anticoagulation prior to COVID-19 infection may impact clinical profile, as well as mortality rate among patients hospitalized with COVID-19. The study was based on retrospective analysis of medical records of patients with laboratory confirmed SARS-CoV-2 infection. After propensity score matching (PSM), a group of 236 patients receiving any anticoagulant treatment prior to COVID-19 infection (AT group) was compared to 236 patients without previous anticoagulation (no AT group). In 180 days, the observation we noted comparable mortality rate in AT and no AT groups (38.5% vs. 41.1%, p = 0.51). Similarly, we did not observe any statistically significant differences in admission in the intensive care unit (14.1% vs. 9.6%, p = 0.20), intubation and mechanical ventilation (15.0% vs. 11.6%, p = 0.38), catecholamines usage (14.3% vs. 13.8%, p = 0.86), and bleeding rate (6.3% vs. 8.9%, p = 0.37) in both groups. Our results suggest that antithrombotic treatment prior to COVID-19 infection is unlikely to be protective for morbidity and mortality in patients hospitalized with COVID-19.


2022 ◽  
Vol 8 ◽  
Author(s):  
Ji Woong Roh ◽  
Seung-Jun Lee ◽  
Byeong-Keuk Kim ◽  
Sung-Jin Hong ◽  
Hee-Yeol Kim ◽  
...  

Background: The impact of ticagrelor-based dual antiplatelet therapy (DAPT) on acute coronary syndrome (ACS) in patients with chronic kidney disease (CKD) remains unclear.Methods: Data on a total of 1,067 ACS patients with CKD including end-stage renal disease (ESRD) who underwent new-generation drug-eluting stent implantation were extracted from a multicenter registry. This study aimed to compare outcomes of patients treated with ticagrelor- (n = 449) and those treated with clopidogrel-based (n = 618) DAPT. Outcomes of interest included major adverse cardiac and cerebrovascular events (MACCEs) and bleeding (Bleeding Academic Research Consortium grade 3 or 5) at 12 months. Propensity-score matching (346 pairs) analysis was performed.Results: The patients with ESRD showed the highest MACCE and bleeding rates (P < 0.001). There was no difference in the rate of MACCEs between the treatment groups (7.8% vs. 8.4%; hazard ratio [HR] = 0.95, 95% confidence interval [CI] = 0.56–1.61, P = 0.855); however, a trend toward an increased bleeding rate was observed in the ticagrelor-based DAPT group (6.8% vs. 3.8%, HR = 1.84, 95% CI = 0.93–3.63, P = 0.079). Among patients with CKD stage III/IV but without ESRD (277 pairs), the ticagrelor-based DAPT group showed a reduced MACCE rate (3.6% vs. 8.7%, HR = 0.41, 95% CI = 0.19–0.86, P = 0.018) and a similar bleeding rate (5.1% vs. 3.2%, HR = 1.61, 95% CI = 0.70–3.71, P = 0.267), compared with those of the clopidogrel-based DAPT group.Conclusion: The effects of ticagrelor-based DAPT on ischemic and bleeding outcomes of ACS patients with CKD varied according to CKD stage; in ACS patients with CKD without ESRD, ticagrelor-based DAPT reduced MACCE risk without increasing bleeding risks, relative to those observed with clopidogrel-based DAPT.


2021 ◽  
Vol 18 (6) ◽  
pp. 57-62
Author(s):  
O. I. Dolgov ◽  
А. V. Gerasin ◽  
А. А. Shcherbakov ◽  
V. E. Pavlov ◽  
S. А. Karpishchenko ◽  
...  

The objective: to assess the incidence and influence of platelets level on the hemorrhagic complications during percutaneous dilated tracheotomy (PDT) in patients with thrombocytopenia.Subjects and Methods. The study included 85 consecutive patients with varying degrees of thrombocytopenia at the stages of hematopoietic stem cell transplantation. The control group included 56 patients who underwent classical tracheotomy. The study group included 29 patients who underwent PDT (Griggs method). The operations were performed for prolonged artificial pulmonary ventilation. When the platelets level was below 20 × 109/L, platelet concentrate transfusion was performed before the operation.Results. The incidence of hemorrhagic complications in patients with thrombocytopenia during PDT was 13.8% (95% CI 9.13–18.45%). In open tracheotomy, the bleeding rate was 3.8% (95% CI 2.65–4.49%). These results are comparable to the incidence of hemorrhagic complications in patients with normal platelet counts. The influence of the platelet level on the presence of hemorrhagic complications in both groups was not established.Conclusion. Thrombocytopenia is not a contraindication to performing PDT. However, platelet concentrate transfusion should be performed in patients with platelet counts less than 20 × 109/L. An experienced team of anesthesiologists and endoscopists can reduce the incidence of other complications.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Yongjuan Liu ◽  
Yongpan Tan ◽  
Rongxia Liu ◽  
Xuekui Ye ◽  
Lina Wang ◽  
...  

Objective. This research was developed to investigate the effect of magnetic resonance imaging (MRI) analysis based on neural network algorithm for cervical ligation in the treatment of cervical insufficiency. Methods. 44 patients who were suspected to be pregnant with cervical insufficiency and needed cervical ligation were selected. MR imaging analysis was performed before cervical ligation. MR images were analyzed based on the back propagation neural network (BPNN) algorithm, and patients were randomly divided into experimental group and control group. Preoperative MRI analysis was performed in the experimental group, while simple transvaginal ultrasonography was used to diagnose cervical insufficiency in the control group. Then, postoperative fetal preservation time, vaginal bleeding rate, and infection rate within one week after surgery were compared between the two groups. Results. Based on experience and experimental testing, the relevant parameters were set as follows. The number of particles n = 50, the inertia weight ω = 0.9, and c1 = c2 = 2. The weight range of the output layer of the neural network was [−1, 1], the target error e = 10−5, and the maximum number of iteration steps was 3,000. Compared with the control group, the experimental group’s postoperative bleeding rate and infection probability were substantially reduced, while the normal delivery rate was substantially increased ( P < 0.05 ). Conclusion. MR image analysis based on neural network algorithm played an important role in cervical cerclage surgery. The image map showed the local anatomy clearly, increasing the success rate of the operation and improving the prognosis of the patient.


Materials ◽  
2021 ◽  
Vol 14 (24) ◽  
pp. 7592
Author(s):  
Hengrui Liu ◽  
Zhenghong Tian ◽  
Haoyue Fan

In this paper, the effect of a newly developed superfine basalt powder (SB) on the fresh and mechanical properties of cement paste was studied. The concept of water film thickness (WFT) was cited to explain the influence of SB on fresh and mechanical properties and related mathematical model formulas were established. In addition, the relationship between the fresh properties and mechanical properties of paste was also explored. The results indicated that SB can improve the segregation resistance and cohesiveness. The maximum improvement rate relative to the control cement paste was 75.4% and 50.4%, respectively. The 5% SB and 10% SB reduced the fluidity in the range of 4.1–68.7% but increased the early and late compressive strength in the range of 1.2–25.7% compared to control cement paste under different water/cementitious materials (W/CM) ratios. However, the influence of 20% SB on fluidity and compressive strength was opposite to the above behavior, and the increase rate and decrease rate were 1.8–11.8% and 1.1–13.9% respectively. The WFT was the most important factor that determined the compressive strength, rheological parameters, and flow parameters of paste containing SB, while the substitute content of SB and WFT together determined the bleeding rate and cohesiveness. Among them, the correlation between bleeding rate and WFT increased with time. The empirical mathematical models between WFT, fresh properties, and compressive strength were established and verified by other mineral admixtures, which were successfully extended and applied to the entire field of cement-based materials


2021 ◽  
Author(s):  
Qingfeng Zhuo ◽  
Lei Ba ◽  
Jing Wang ◽  
Qifeng Wang

In view of the high cost of cement filling, the new cementitious materials are developed by using solid waste resources. Firstly, on the basis of material physicochemical analysis, the fly ash composite cementation ratio test and optimization test are carried out to determine the optimal ratio. Then, the filling body strength and pipeline transportation characteristics test are carried out to analyze they influence law. Finally, the genetic algorithm is used to optimize the slurry ratio. The results show that the strength of cemented backfill increases linearly with the increase of slurry concentration; The slump and bleeding rate of slurry decrease with the increase of slurry mass fraction, and increase with the decrease of binder sand ratio, the optimal proportion of fly ash (FA) based composite binder is w(FA): w(clinker): w (desulfurized gypsum (DG)): w (slag powder (SP)) =40:12:12:36; The optimum slurry ratio is 1:4 of binder/sand and 72% of concentration.


Agronomy ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2457
Author(s):  
Tianyao Meng ◽  
Xi Chen ◽  
Xubin Zhang ◽  
Jialin Ge ◽  
Guisheng Zhou ◽  
...  

Since genetic improvement greatly promoted an increased yield japonica inbred rice in east China after the 1990s, better root characteristics were certainly expected. In 2018 and 2019, nine japonica inbred rice released in the 1990s, 2000s, and 2010s were investigated to evaluate the changes in root morpho-physiology and identify root traits that contributed to the positive yield trends during the genetic process. The 2010’s rice had 8.0 and 4.3% higher grain yield than the 1990’s and the 2000’s rice, respectively (p < 0.05). Genetic yield gain was mainly attributed to the increased spikelets per panicle. Compared with the 1990’s and the 2000’s rice, the 2010’s rice had higher shoot biomass at heading and maturity (p < 0.05), as well as root biomass (p < 0.05), especially for root biomass of 15–30 cm soil depth. Leaf area index (LAI), soil-plant analysis development (SPAD) values, and leaf photosynthetic rate at middle grain-filling period (MGP) and late grain-filling period (LGP) were all increased. The 2010’s rice had consistently higher root length and volume, root oxidation activity, and root bleeding rate at MGP and LGP than the 1990’s and the 2000’s rice (p < 0.05). Positive correlations were detected between root length and volume, root oxidation activity, and root bleeding rate at MGP, LGP, and SPAD values, leaf photosynthetic rate at MGP and LGP, and higher shoot biomass accumulation after heading and grain yield (p < 0.05 or p < 0.01). The present study implied that genetic improvement optimized post-heading root morphology and physiology, which maintained shoot stay-green and facilitated biomass accumulation and yield increase in japonica inbred rice during the genetic process since the 1990s.


2021 ◽  
Vol 9 ◽  
Author(s):  
Wei Yin ◽  
Kun Zhang ◽  
Shenyang Ouyang ◽  
Xiaomin Bai ◽  
Wenjie Sun ◽  
...  

In coal mining, the problems of massive discharge of solid waste, environmental pollution, and surface subsidence disaster are urgent to be solved. Based on this engineering background, the feasibility of using solid waste soda residue to improve gangue cemented backfilling material was discussed, and the surface subsidence of the test working face was measured in this study. Besides, the influence of soda residue on the performance of gangue cemented backfilling materials was analyzed through laboratory tests. The experimental results show that 1) as the content of soda residue increases within the range of 0–12%, the slump of the soda residue gangue backfilling material (SRGBM) slurry gradually increases, and the bleeding rate increases. The early strength and later strength of SRGBM increase first and then decrease with the increase in soda residue content. 2) The optimal ratio of the soda residue cemented backfilling material is soda residue: fly ash: lime: cement: gangue = 6%: 34%: 10%: 2.5%: 47.5%. Compared with the reference group, the slump of the material is increased by 12.7%, the bleeding rate is only 3.8%, and the early strength and later strength are increased by 449 and 187%, respectively. 3) The addition of soda residue promotes the hydration reaction of the slurry system of soda residue cemented materials. The coexistence of C-S-H gel and N-A-S-H gel reduces the connectivity of pores and improves the strength of the material. 4) The maximum surface subsidence of the test working face is only 245 mm, and the surface subsidence control effect is good. Therefore, the preparation of SRGBM with soda residue can achieve energy saving and emission reduction, with significant technical, economic, and social benefits, and has good promotion and application value.


2021 ◽  
Vol 11 (21) ◽  
pp. 10491
Author(s):  
Jianxiu Wang ◽  
Ansheng Cao ◽  
Zhao Wu ◽  
Huanran Wang ◽  
Xiaotian Liu ◽  
...  

For an ultra-shallow buried double-arch tunnel with a large cross-section, the arching effect is difficult to form in surrounding rock, and grouting method is often adopted to reinforce the surrounding rock. Hence, examining the grouting reinforcement parameters is of great significance for potential failure and collapse prevention. The land part of Haicang undersea tunnel was selected as a case study; laboratory experiments, theoretical analysis, and numerical simulation were performed to determine the grouting solid strength and grouting reinforcement parameters. The effects of different water–cement ratios on slurry fluidity, setting time, bleeding rate, and sample strength were studied by laboratory experiments. A method was proposed to determine the shear strength parameters of grouted surrounding rock through the grout water–cement ratio and the unconfined compressive strength of the rock mass. Numerical simulations were performed for grouting reinforcement layer thickness and the water–cement ratios. The deformation and stability law of tunnel surrounding rock and its influence on surrounding underground pipelines were obtained considering the spatial effect of tunnel excavation and grouting reinforcement. The reasonable selection range of grouting reinforcement parameters was proposed. The initial setting time and bleeding rate of cement slurry increased with the increasing water–cement ratio, while the viscosity of cement slurry and sample strength decreased with the increasing water–cement ratio. The shear strength parameters of grouted surrounding rock were determined by the water–cement ratio of grout and unconfined compressive strength of rock mass before grouting. When the thickness of grouting reinforcement layer h = 1.5 m and the water–cement ratio of grout was suggested η = 0.85, the surface settlement, the deformation of the vault, and the deformation of the nearby pipeline all met the design. Moreover, the construction requirements were more economical. Research results can provide a reference for the selection of grouting reinforcement parameters for similar projects.


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