Phenotyping bleeding

Abstract

Purpose of review Although recorded evidence of phenotyping bleeding disorders extends back two millennia, standardization of phenotyping has only begun in the past half century. This was spurred by the need for greater precision in diagnosing disorders in order to select proper laboratory tests and treatment, and the realization that the bleeding history provides prognostic information about the future risk of bleeding with surgery or invasive procedures. Recent findings New bleeding assessment tools (BATs) have been developed to: 1. evaluate the relative bleeding risks associated with new anticoagulants and antiplatelet agents, 2. assess the efficacy of new thrombopoiesis stimulating agents in preventing hemorrhage in patients with immune thrombocytopenia, and 3. assess complex gene-gene and gene-environment interactions. New web-based systems allow many researchers to collaborate by sharing the same electronic phenotyping infrastructure. Major issues of validation remain, but at present, the data indicate that the new BATs have relatively high negative predictive value for excluding a significant bleeding disorder, but disappointingly low positive predictive values. Summary New instruments to phenotype bleeding have been developed to address a number of different important clinical and research goals. The improved standardization and opportunities for collaborative studies hold promise for maximizing diagnostic, prognostic, and scientific information.

The Effect of Sulphated Cellulose on Haemostasis

“…The maximum plasma аXа activity was noted in the 5th minute after the administration of SC BOS-122 and heparin into the blood, which coincides with the literature on the intravenous administration of the direct anticoagulant heparin (James, Coller, 2012). The complete disappearance of the aXa activity in the rabbit plasma was observed with the introduction of only heparin at doses of 0.75 and 1 µg/kg after 170 and 110 minutes, which is consistent with the data on the plasma coagulation time in the APTT and ReаClot-Heparin tests.…”

Bleeders, bleeding rates, and bleeding score

“…Bleeding has always been an alarming clinical symptom in all human societies, and physicians have had varying degrees of success in diagnosing and treating bleeding patients . Unlike other clinical manifestations, however, bleeding is likely to become even more common in the future, largely due to the ever‐increasing use of antiplatelet or anticoagulant drugs in frail patients .…”

Bleeding management in pediatric patients

“…Bleeding has always been an alarming clinical symptom in all human societies, and physicians have had varying degrees of success in diagnosing and treating bleeding patients [ 1 ]. Because bleeding is part of the human experience, one the most challenging tasks for a physician is to discriminate between “normal” and “pathologic” bleeding.…”