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See detailThrombose portale étendue chez un patient sous anti-vitamine K
LEDOUBLE, Vinciane ULg; BECK, Emmanuel ULg; PETERS, Pierre ULg et al

in Revue Médicale de Liège (2013), (68(7-8)), 382-6

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See detailPersistent hypocoagulability in patients with septic shock predicts greater hospital mortality: impact of impaired thrombin generation.
MASSION, Paul ULg; PETERS, Pierre ULg; LEDOUX, Didier ULg et al

in Intensive Care Medicine (2012), 38(8), 1326-35

PURPOSE: Sepsis induces hypercoagulability, hypofibrinolysis, microthrombosis, and endothelial dysfunction leading to multiple organ failure. However, not all studies reported benefit from anticoagulation ... [more ▼]

PURPOSE: Sepsis induces hypercoagulability, hypofibrinolysis, microthrombosis, and endothelial dysfunction leading to multiple organ failure. However, not all studies reported benefit from anticoagulation for patients with severe sepsis, and time courses of coagulation abnormalities in septic shock are poorly documented. Therefore, the aim of this prospective observational cohort study was to describe the coagulation profile of patients with septic shock and to determine whether alterations of the profile are associated with hospital mortality. METHODS: Thirty-nine patients with septic shock on ICU admission were prospectively included in the study. From admission to day 7, analytical coagulation tests, thrombin generation (TG) assays, and thromboelastometric analyses were performed and tested for association with survival. RESULTS: Patients with septic shock presented on admission prolongation of prothrombin time, activated partial thromboplastin time (aPTT), increased consumption of most procoagulant factors as well as both delay and deficit in TG, all compatible with a hypocoagulable state compared with reference values (P < 0.001). Time courses revealed a persistent hypocoagulability profile in non-survivors as compared with survivors. From multiple logistic regression, prolonged aPTT (P = 0.007) and persistence of TG deficit (P = 0.024) on day 3 were strong predictors of mortality, independently from disease severity scores, disseminated intravascular coagulation score, and standard coagulation tests on admission. CONCLUSIONS: Patients with septic shock present with hypocoagulability at the time of ICU admission. Persistence of hypocoagulability assessed by prolonged aPTT and unresolving deficit in TG on day 3 after onset of septic shock is associated with greater hospital mortality. [less ▲]

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See detailAnticoagulants oraux : nouveaux horizons
PETERS, Pierre ULg; DEFRAIGNE, Jean ULg; GOTHOT, André ULg

in Revue Médicale de Liège (2012), 67

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See detailComparison of the platelet concentrations obtained in platelet-rich plasma (PRP) between the GPS™ II and GPS™ III systems
Kaux, Jean-François ULg; Le Goff, Caroline ULg; Renouf, Julien et al

in Pathologie Biologie (2011), 59(5), 275-277

Introduction Platelet growth factors are known for their ability to speed up tissue healing (bone, skin, tendons, muscle). Various techniques make it possible to collect this platelet-rich plasma or PRP ... [more ▼]

Introduction Platelet growth factors are known for their ability to speed up tissue healing (bone, skin, tendons, muscle). Various techniques make it possible to collect this platelet-rich plasma or PRP. Methods This study compares the platelet concentrations obtained from five patients using GPS™ III, which has recently come onto the market, with those obtained using GPS™ II. Results and conclusion We obtain a platelet concentration that is six to nine times greater with GPS ™ II and GPS™ III, but there is no significant difference between the concentrations of PRP obtained with the two systems. [less ▲]

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See detailEtude comparative de 5 techniques de préparation plaquettaire (Platelet-Rich Plasma)
Kaux, Jean-François ULg; Le Goff, Caroline ULg; Seidel, Laurence ULg et al

in Pathologie Biologie (2011), 59

Aim of the study: Injections of platelet-rich plasma (PRP) constitute a new therapeutic for treating chronic tendinopathies. The injection being carried out in the tendon, the volume of PRP should thus be ... [more ▼]

Aim of the study: Injections of platelet-rich plasma (PRP) constitute a new therapeutic for treating chronic tendinopathies. The injection being carried out in the tendon, the volume of PRP should thus be minimal (to decrease the intra-tendinous pressure and to minimize pain). This PRP should also have a raised platelet count. The quantity of released growth factors could be related to the system of preparation employed. We thus carried out a comparative study of 5 techniques of preparation of PRP described in the literature. Patients and methods: Samples of venous blood were taken among 5 patients in order to compare 5 techniques of preparation of PRP: University Hospital of Liège technique, Curasan® PRP Kit, Plateltex®, GPS® and RegenLab®. Results: The various techniques make it possible to obtain more important platelet concentration than in blood, with variable volumes (0,3 mL to 6 mL). The number of platelets/microlitre appears higher with Plateltex® and obtains smallest volume of PRP. The other techniques also give small volumes excepted for the GPS® II. The number of collected platelets with this technique appears thus higher. The best collect efficiency is obtained with RegenLab®. Conclusion: The technique Plateltex® makes it possible to collect the highest concentration of platelets in the smallest volume available. [less ▲]

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See detailSurgical resection of a sphenoid wing meningioma in a patient with Glanzmann thrombasthenia.
WERTZ, Damien ULg; Boveroux, Pierre ULg; PETERS, Pierre ULg et al

in Acta anaesthesiologica Belgica (2011), 62(2), 83-6

Glanzmann thrombasthenia (GT) is a rare autosomal recessive disorder characterized by a deficiency or functional defect of platelet glycoprotein (GP) IIb/IIIa. Physiologically, this platelet receptor ... [more ▼]

Glanzmann thrombasthenia (GT) is a rare autosomal recessive disorder characterized by a deficiency or functional defect of platelet glycoprotein (GP) IIb/IIIa. Physiologically, this platelet receptor mediates aggregation of activated platelets by binding the adhesive proteins, fibrinogen, von Willebrand factor (VWF) and fibronectin. This facilitates attachment and aggregation of platelets at sites of vascular injury. We reported the management of a pterional meningioma resection in a patient with Glanzmann thrombasthenia, with recombinant factor VIIa (rFVIIa - NovoSeven) as haemostatic agent. A 48-year-old woman suffering from Glanzmann thrombasthenia was scheduled for spheno-orbital meningioma en plaque surgery. Because of repeated platelet transfusions, this patient developed isoantibodies against missing GPIIbIIIa and alloantibodies against Human Leukocyte Antigen (HLA) leading to refractoriness to platelet transfusions. We observed that Novoseven offered sufficient haemostasis conditions. Therefore, we noticed a deep vein thrombosis. This imposed us to use low weight molecular heparin despite recent surgery. [less ▲]

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See detailGPS™ II and GPS™ III: comparison of obtained platelets concentrations
Kaux, Jean-François ULg; Le Goff, Caroline ULg; Renouf, Julien et al

Poster (2010, March 20)

Introduction: Recently, several researches, essentially in vitro, demonstrated the positive effects of platelets on healing process of different tissues: bones, muscles and tendons. The aim of this study ... [more ▼]

Introduction: Recently, several researches, essentially in vitro, demonstrated the positive effects of platelets on healing process of different tissues: bones, muscles and tendons. The aim of this study is to compare the obtained platelets concentration between the new GPS™ III and GPS™ II. Methods: Two blood samples of 52 mL were taken in 5 volunteers and transferred respectively in both GPS™ II and GPS™ III. These devices were centrifuged at 3200 RPM during 15 min. The platelet-rich plasma (PRP) was thus collected and transferred in 6 mL test tubes. Cells count was done using an analyser ABX Micros 60. Results and conclusion: Platelets concentrations were more important from 6.2 up to 9.2 times with GPS™ II and from 7.3 up to 8.3 times with GPS™ III compared to blood samples. Efficiency of the collected platelets was around 92% for GPS™ II and 96% for GPS™ III. Both techniques made it possible to collect platelets but, unfortunately, also a lot of red and white blood cells. None of these parameters showed any significant difference (p>0.05). Conflicts of interests: The 10 devices GPS™ II and GPS™ III were provided gracefully by the firm Biomet Biologics TTC. [less ▲]

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See detailComparaison de 5 techniques de prération du PRP (Platelet-Rich Plasma ou plasma)
Kaux, Jean-François ULg; Le Goff, Caroline ULg; Seidel, Laurence ULg et al

in Annales de Réadaptation et de Médecine Physique (2009, October), 52(Sup. 1), 109

Introduction : Depuis une vingtaine d’années, le développement des activités sportives s’accompagne d’une incidence accrue de diverses tendinopathies, souvent rebelles aux traitements conservateurs ... [more ▼]

Introduction : Depuis une vingtaine d’années, le développement des activités sportives s’accompagne d’une incidence accrue de diverses tendinopathies, souvent rebelles aux traitements conservateurs classiques (anti-inflammatoires non stéroïdiens, orthèses, kinésithérapie, infiltrations…). De nouvelles thérapeutiques, dont l’injection de concentrés plaquettaires (plasma riche en plaquettes ou PRP), sont actuellement en cours d’évaluation clinique. Objectifs : L’injection de PRP fait actuellement l’objet de recherche comme thérapeutique des tendinopathies chroniques. L’injection intra-tendineuse nécessite idéalement un volume minimal afin de diminuer la pression lors de l’injection et minimiser les douleurs, mais il doit également présenter une concentration plaquettaire élevée ; par ailleurs, la quantité de facteurs de croissance libérés pourrait être liée au système de préparation. Méthodes : Après avoir prélevés divers échantillons de sang veineux chez 5 patients, nous avons comparé 5 techniques de préparation du PRP : celle du Service d’Hématologie Biologique du CHU de Liège, le PRP Kit de Curasan®, les techniques Plateltex®, GPS®II et RegenLab®. Résultats : Les différentes techniques permettent d’obtenir des concentrations plaquettaires plus importantes que dans le sang avec des volumes variables (de 0,3 mL à 6 mL) et un nombre de globules rouges et globules blancs limité (sauf pour GPS® II). Le nombre de plaquettes/µL apparaît plus élevé avec la technique Plateltex® et obtient le plus petit volume à injecter. Les autres techniques permettent également d’obtenir de petits volumes sauf avec le GPS®II. Le nombre de plaquettes collectées dans le PRP apparaît donc plus élevé avec cette technique mais avec une concentration faible. Discussion – Conclusion : La technique décrite par Plateltex® permet de recueillir le PRP le plus concentré dans le volume le plus faible. [less ▲]

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See detailLa Thrombinographie : vers une globalisation des tests de la coagulation.
Peters, Pierre ULg; Gothot, André ULg

in Revue Médicale de Liège (2009), 64(4), 199-203

Thrombin is the key enzyme of coagulation and thrombin generation is the central haemostatic process. Current clotting tests (PT, aPTT) measure the time at which the first fibrin filaments appear after ... [more ▼]

Thrombin is the key enzyme of coagulation and thrombin generation is the central haemostatic process. Current clotting tests (PT, aPTT) measure the time at which the first fibrin filaments appear after activation of coagulation . Yet, more than 95% of thrombin is generated after clot detection, which underlies the poor sensitivity of usual clotting tests for the detection of many hemorragic or thrombotic diseases. Thrombinography measures the kinetics of thrombin generation and inactivation during ex vivo coagulation, in standardized conditions. Thrombin generation is reduced in hemophiliacs and in patients under anticoagulant treatment. Thrombin activity is raised in hypercoagulable states, such as antithrombin deficiency, protein C and S deficiency, facteur V Leiden and in women under oral contraceptives. Thrombin generation is delayed but amplified in the presence of lupus anticoagulants. In platelet-rich plasma, thrombin generation detects thrombopathies and von Willebrand disease, and allows monitoring of antiplatelet drugs. Thrombinography allows for a global phenotype of the thrombosis-hemostasis system. [less ▲]

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