Bypassing Agents for Bleeding Reduction in Treatment of Bleeding Episodes in Patients With Haemophilia and Inhibitors

Golestani, Mina; Eshghi, Peyman; Rasekh, Hamid Reza; Cheraghali, Abdol Majid; Salamzadeh, Jamshid; Imani, Ali

doi:10.5812/ircmj.24551

Cited by 3 publications

(4 citation statements)

References 34 publications

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“…In line with the studies on the health of bus drivers, this study suggests that by concentrating on improving worker health (including improving physical and mental health of drivers), reducing fatigue and reducing alcohol intake, tobacco and drug use, a reduction in the accident rate in buses, Job-shift staffing and driver absences can be predicted [ 35 ]. The quality of patient care is affected by many factors, one of the most important issues in this regard being the increase in drug costs [ 36 – 38 ]. The merit of the present study is that it is one of the first Iranian studies aiming at examining a variety of epidemiological characteristics and possible reasons for BuMUs mortalities over 12 years in the East Azerbaijan province of Iran.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran

Sadeghi‐Bazargani¹,

Samadirad²,

Golestani³

et al. 2018

JMedLife

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Objective The aim of this study was to investigate the epidemiological features of bus/minibus users’ road traffic injury mortalities during 2006-2017, in the East Azerbaijan province of Iran. Methods All 245 bus/minibus users’ mortalities, registered in the forensic medicine database, were analyzed by STATA 13 statistical software package. Results The majority of victims (mean age: 41.5±18.6 years) were men (70%), adults (79.18%), illiterate (22.4%) and self-employed (25.3%). Passersby and police played an almost null role in transporting victims since 2014. A decreasing trend of bus/minibus users’ fatalities was observed over the study time. Head-neck-face trauma was more common among those who died prior to hospitalization. Rollover was significantly prevalent among bus users and falling among minibus users. Lorries, vans, and trailers as crash counterpart vehicles caused 59% of deceases, excluding the cases when no other vehicle was engaged. Victims were more likely to die at the hospital when crashes happened in the city’s inner roads (OR: 4.17; 95%CI:1.7-9.9). The elderly were 2.78 times more likely to die at the hospital when compared to the other age groups (95%CI: 1.23-6.26). Conclusions To identify a target group for interventions on traffic-related knowledge, attitude and behaviors, male adults, illiterate and self-employed bus/minibus users could be of priority. Type vehicles involved in the crash should be considered as an important factor affect on crash fatalities. Further investigations are needed in this regard in the future.

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Section: Discussionmentioning

confidence: 99%

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran

Sadeghi‐Bazargani¹,

Samadirad²,

Golestani³

et al. 2018

JMedLife

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“…Different dose of rFVIIa was calculated for patients suffering from TJ bleedings with or without synovectomy (SV) or radio-synovectomy (RSV). [ 23 ] In addition, based on literature the rFVIIa dose needed for general operations or arthroplasty was considered 9.24 mg/kg. [ 24 ]…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, the required dose of rFVIIa OD treatment was defined for those types of bleeding mentioned in the HAVEN1 study. Different dose of rFVIIa was calculated for patients suffering from TJ bleedings with or without synovectomy (SV) or radio-synovectomy (RSV) [23] . In addition, based on literature the rFVIIa dose needed for general operations or arthroplasty was considered 9.24 mg/kg [24] …”

Section: Methodsmentioning

confidence: 99%

A comparison between on-demand usage of rFVIIa vs prophylaxis use of emicizumab in high titer inhibitory hemophilia A patients in Iran

et al. 2021

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Background: Hemophilia A (HA) is an inherited X-linked bleeding disease with costly treatment, especially for high titer inhibitory patients. Emicizumab, a new humanized bispecific antibody, has been approved for use to prevent or reduce the frequency of bleeding episodes in HA patients with inhibitors. This study evaluated the cost-utility of emicizumab prophylaxis (EP) in comparison with recombinant factor VII activated on-demand treatment in HA patients with inhibitors. Methods: A life-time Markov model with payer and societal perspectives was developed in different age groups with different annual bleeding rates (ABR). Efficacy of treatments were extracted from HAVEN trials. Utilities were retrieved from published evidence. Costs were calculated based on Iran food and drug administration official website, national tariff book for medical services and hospital data. One-way deterministic sensitivity analysis was performed. Results: EP was dominant choice in comparison with on-demand administration of recombinant factor VII activated in all age groups with ABR 20 and 25, and it remained dominant in patients with age 2 and age 12 at start point with ABR 16 and 17. The reported incremental cost-effectiveness ratio for the group with ABR 18 at the age 20, was 12,936 United States Dollars which is lower than the acceptable threshold of cost-effectiveness in Iran (1–3 gross domestic product per capita) and EP can be considered as cost-effective choice in this scenario. Conclusion: EP was found to be a dominant and cost-effective choice for Iranian HA patients with factor VIII inhibitors with ABR 18 and above with considerable cost saving.

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“…Согласно современным представлениям, в очаге нарушенного кровоснабжения мышечной ткани происходит снижение концентрации аденозинтрифосфорной кислоты (АТФ) и креатинфосфата при одновременном увеличении содержания аденозиндифосфорной кислоты (АдФ) и неорганического фосфора, что влечет за собой активацию и последующий распад митохондрий, контрактуру и некробиоз миофибрилл, прекращение деятельности АТФ-зависимых мембранных ионных насосов и последующую дезинтеграцию клеточных структур, т.е. эти ферментные нарушения могут привести к развитию некроза мышечных волокон [1,4].…”

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Study of Clinical and Biochemical Indicators in Muscle Pathology Among Patients With Hemophilia

Madasheva¹,

Махмудова²,

Berger³

2021

TBEM

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Aim. Determine the state of the biochemical composition of blood in the midst and resolution of muscle hematomas in patients with hemophilia.Materials and methods. 118 patients with hemophilia were examined. These patients were inpatient treatment at the hemophilia center at the Republican Specialized Scientific and Practical Hematology Center of the Ministry of Health of the Republic of Uzbekistan. The control group consisted of 40 apparently healthy men of the same age. Results. Signs of massive hemorrhages in the tissue are an increase in the blood level of the activity of the cytoplasmic enzyme aspartate aminotransferase (54.1 ± 3.9 and 18 ± 4.1, respectively) and alanine aminotransferase (55.3 ± 5.2 and 27.3 ± 4.4, respectively). Depending on the severity of the breakdown of muscle fibers and the rate of progression of the complication, the increase in CPK activity in myopathies can be either sharp - 680.7 ± 14.2 IU / L (hemophilic tumor, tissue necrosis), or, conversely, insignificant 120.3 ± 11.1 IU / L (muscle tissue contracture or atrophy). Deficiency of serum iron (6.4 ± 1.1 μmol / L) was revealed in all groups of examined patients with hemophilia. There was a tendency to lower cholesterol content to 3.3 ± 0.2 mmol / L. The content of urea, as the end product of protein metabolism, was higher in hemophilia patients with a syndrome of necrotic changes in hematomas – in 4 patients (9.8 ± 2.2 mmol / l), which, in our opinion, is associated with an increase in the breakdown of hemoglobin and other proteins with massive hemolysis of erythrocytes in tissues. The study of trace elements in the blood serum revealed a deficiency of Mg²+ 1.6 times, Ca²+ 2.1 times.Conclision. In patients with hemophilia with hemorrhages in muscle tissue, there was a tendency to lower cholesterol and iron levels, and an increase in the amount of bilirubin. The “key” enzymes for the diagnosis and prognosis of complications can be a dynamic study of the activity of the levels of CPK (creatine phosphokinase) and ALT (alanine aminotransferase), AST (aspartate aminotransferase).

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Bypassing Agents for Bleeding Reduction in Treatment of Bleeding Episodes in Patients With Haemophilia and Inhibitors

Cited by 3 publications

References 34 publications

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran

A comparison between on-demand usage of rFVIIa vs prophylaxis use of emicizumab in high titer inhibitory hemophilia A patients in Iran

Study of Clinical and Biochemical Indicators in Muscle Pathology Among Patients With Hemophilia

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