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Jul 2017 DOI 10.14302/issn.2639-1716.jn-17-1499
Abu Arab WalidCorresponding author
Service de Chirurgie thoracique, Université de Sherbrooke, Québec, Canada
Non-small cell lung cancer is a major health problem worldwide. Surgery is still the mainstay of treatment especially in early stages of the disease. Despite the fact that surgery is the potentially curative treatment, the recurrence and mortality rates are still high specifically with more advanced stages of cancer. Heparin has been suggested to have a positive impact on the outcome of various cancers through its anticoagulants properties and; in some instances; due to their antitumor activity. Recently, the molecular mechanisms of tumor cell spreading have been recognised. Metastasis is a complex process that could be therapeutically affected wherever certain extra-cellular matrix proteins could play an important role in prevention of tumor cell migration and invasion. Experimental studies have shown decreased metastases development after heparin use in rat models. We have reviewed the literature to study the role of anticoagulants in cancer patients in general and in patients with Non Small Cell Lung Cancer (NSCLC) specifically.
Aug 2021 DOI 10.14302/issn.2372-6601.jhor-21-3903
B Katakkar SureshCorresponding author
Arizona Hematology Oncology, Tucson Arizona USA
A 61 years female patient with known diagnosis of the breast cancer in remission for more than 10 years has Renaud’s disease. During her work up for lupus and lupus anticoagulant which both were negative a prolonged thrombin time was noted which was done by mistake. She has no history of bleeding or thrombosis and last recent surgery was 5 years ago for spinal stenosis and was uncomplicated. Her clinical examination is normal without evidence of any spontaneous bruises but colder hands. The thrombin time was greater than 125 seconds on two different occasions and correction of it by addition of normal plasma was down to 56 seconds and was thus incomplete. Her prothrombin time and PTT were normal and there was no evidence of FDP or D-Dimers. There was no evidence of circulating heparins. The fibrinogen level was normal. The para proteinmia was excluded by normal serum protein electrophoresis and by immunofixation . Thus it is felt that this patient has dysfibrinogenemia or hypo dysfibrinogenemia without bleeding or thrombotic complication. The literature review shows approximately 55% of dysfibrinogenemia patients do not have bleeding or thrombotic complications.
Mar 2016 DOI 10.14302/issn.2329-9487.jhc-13-332
P. Desai ArpanCorresponding author
Interventional Cardiologist, Vadodara, Gujarat, India.
Objective: The objective of this study was to evaluate the efficacy of patent haemostasis in avoiding radial artery occlusion after transradial catheterization. Background: Radial artery occlusion is an infrequent but discouraging complication of transradial access. It is related to factors such as sheath to artery ratio and is less common in patients receiving heparin. Despite being clinically silent in most cases, it limits future transradial access. Patients and Methods: 130 patients undergoing transradial catheterization were prospectively enrolled in the study. 65 patients were randomized to group I, and underwent conventional pressure application for haemostasis. 65 were randomized to group II and underwent pressure application confirming radial artery patency using Barbeau’s test. Radial artery patency was studied at 24 hr and 30 days using Barbeau’s test. Results: There was Statistically significant difference found in rate of radial artery occlusion of both the groups at 24 hours (24.61% vs. 4.61% ,X2(1)=4.44, P<0.05) and at 30 days(20% vs. 3%,X2(1) =4.03, P < 0.05). Patients with Higher age and smaller radial artery diameter were at significantly higher risk of radial artery occlusion. No other procedural variables were found to be associated with radial artery occlusion. Conclusion: Patent haemostasis is highly effective in reducing radial artery occlusion after radial access and guided compression should be performed to maintain radial artery patency at the time of haemostasis, to prevent future radial artery occlusion.