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Amyloid Fibrils Of Human Fgf-1 Induced By Different Detergents, Zeina Ismael Ibrahem Alraawi

Graduate Theses and Dissertations

Nature achieves molecular self-assembly through the ordered growth of nanoscale building blocks with high efficiency to fabricate macromolecular architectures. One example of self- assembly is peptides folding onto protein is one of the most astounding biological self-assembly processes. When proteins aggregate to form amyloid fibers, the secondary structure of the protein converts from its native state to a cross-beta-sheet. Fibroblast growth factors (FGFs) possess an essential role in neuronal survival during development. In addition, they are involved in neural stem cell (NSC) proliferation. Fibroblast growth factors (FGFs) are well known to be synthesized in the central nervous system (CNS) and …

The Standard Of Care Is Standard For A Reason: Commentary On "Optimal Dosing Of Heparin For Prophylactic Anticoagulation In Critically Ill Covid-19 Patients: A Systematic Review And Meta-Analysis Of Randomized Clinical Trials", Victoria Milano, Jacob Hurt, Nathan D. Nielsen

Pathology Research and Scholarship

No abstract provided.

Treatment Of Blunt Cerebrovascular Injury - A Systematic Review And Meta-Analysis, Multicenter Retrospective Review, And Protocol For A Feasibility Randomized Controlled Trial, Jovana Momic

Electronic Thesis and Dissertation Repository

Blunt cerebrovascular injury (BCVI) is an often-overlooked clinical problem that can result in stroke and cause devastating, potentially permanent, neurologic disabilities in young and otherwise healthy trauma patients. Early diagnosis and treatment of BCVI can reduce the risk of stroke and prevent disability, however, treatment also carries a risk of bleeding complications. More research is needed to understand the optimal management strategy to reduce the risk of stroke while minimizing bleeding complications.

The aim of this thesis is to review and critically appraise the literature to better understand the efficacy of various treatment strategies in preventing stroke following BCVI, evaluate …

Studying The Stability Of Collagen/Heparin Coatings To Be Used In Cell Therapy Applications, Gavin Mussino

Biological Sciences Undergraduate Honors Theses

This honors thesis aims to investigate the reusability and performance of cell coatings for cell therapy applications. Cell therapy, which involves the use of human cells to repair or replace damaged tissues, holds immense potential for medical advancements. However, ensuring the survival and functionality of transplanted cells remains a significant challenge. We focused on studying the effectiveness of coatings applied to cells for improved cell growth and viability. The research project involved the preparation of the coatings using a layer-by-layer method and the subsequent seeding of cells. The coated cells were then subjected to a series of experiments to assess …

Anticoagulant And Anti-Sars-Cov-2 Effects Of Botryocladia Occidentalis Sulfated Glycans, Reena Thara

Honors Theses

Marine algal species are composed of various macromolecules endowed with potential biological actions, such as carbohydrates. Sugars are complex in nature with a multitude of monosaccharides constructed into polymers. We call complex carbohydrate polysaccharides those of great structural variation. The sulfation pattern adds to their complexity, creating scientific interest in the aquatic organisms from which these molecules can be extracted. Sulfated polysaccharides are now increasingly studied for their potential biological properties as anticoagulants and as antivirals. Heparin is a naturally occurring sugar in the human body that is necessary for proper anticoagulation. Many people today suffer from a dysfunctional coagulation …

Study Of The Stability Of Heparin/Collagen Layer-By-Layer Coatings, Hector M. Apodaca Reyes

Chemical Engineering Undergraduate Honors Theses

Pairing heparin with collagen-based medical implants has opened a whole new area of research for enhancing the desired effect of current implants. In fact, heparin (HEP) and collagen (COL) layer-by-layer (LbL) coatings have shown impressive results in forming polyelectrolyte multilayers. It has been already seen on skin grafts, nerve guide conduits (NGCs), and drug delivery devices yielding promising results. Due to being a simple, cost-efficient, and versatile option to fabricate thin biomimetic films, this self-assembly technique is one of the most effective methods to immobilize extracellular matrix (collagen and heparin) onto medical devices and implants. Even though previous studies have …

A Case Of Malignant Atrophic Papulosis With Septic Complications, Mengjiao Tao, Kaiwen Zhuang, Yaowen Jiang, Wayne Bond Lau, Yarong He

Department of Emergency Medicine Faculty Papers

No abstract provided.

Transitions To Normal Saline Only For Cvads, Megan Lehn, Ann Backes

Nursing Posters

Purpose Statement:

The purpose of this project is to implement a practice change throughout the system to remove heparin flushes for Central Venous Access Devices (CVADS) pending a successful pilot on Medical Oncology.

Synthesis of Evidence:

• Shama et al (2019) conducted a systematic review and meta-analysis including 886 participants that revealed no clear differences in CVC patency between heparin and NS.
• Klein et al (2018) conducted a pilot study on a 30-patient bone marrow transplant unit, each patient had a new CVC and were divided into two groups. Among 698 catheter-associated events overall incidence of central line issues were similar …

Interactions Of Marine Sulfated Glycans With Antithrombin And Platelet Factor 4, Wenjing Zhang, Weihua Jin, Vitor H. Pomin, Fuming Zhang

Faculty and Student Publications

The molecular interactions of sulfated glycans, such as heparin, with antithrombin (AT) and platelet factor 4 (PF4) are essential for certain biological events such as anticoagulation and heparin induced thrombocytopenia (HIT). In this study, a library including 84 sulfated glycans (polymers and oligomers) extracted from marine algae along with several animal-originated polysaccharides were subjected to a structure-activity relationship (SAR) study regarding their specific molecular interactions with AT and PF4 using surface plasmon resonance. In this SAR study, multiple characteristics were considered including different algal species, different methods of extraction, molecular weight, monosaccharide composition, sulfate content and pattern and branching vs. …

Prophylactic Measure In Women With Early Recurrent Pregnancy Loss, Polycystic Ovary Syndrome, And Hyperhomocysteinemia, Abd El-Hamid E. Shahin, Mohamed S. Gad, Samia M. Ghonim

Menoufia Medical Journal

Objective This work aims to evaluate prophylactic measures against early recurrent pregnancy loss (RPL) in women with polycystic ovary syndrome (PCOS) and hyperhomocysteinemia. Background PCOS is the most common endocrine disorder in females; hyperhomocysteinemia is frequently associated with PCO. Mild-to-moderate hyperhomocysteinemia increases the risk of RPL through augmentation of hypercoagulable state of pregnancy and thrombosis in maternal and fetal circulation. Patients and methods The study was a randomized prospective comparative study. Patients in this study were 60 patients aged between 20 and 35 years with PCOS that was diagnosed according to the Rotterdam criteria if at least two of the …

Urticarial Rash In A Patient With Alpha-Gal Syndrome Caused By Subcutaneous Heparin At Prophylactic Dosing: A Case Report, Russell G. Behmer, Randolph S. Thomas, Hani T. Jarawan

Journal of Maine Medical Center

Introduction: We report a patient with a history of red meat allergy, or alpha-gal syndrome, who had an urticarial rash after exposure to unfractionated heparin at a dose typically used for prophylaxis of deep venous thrombosis. Although anaphylactic reactions have been reported with systemic intravenous heparin, we believe this case is the first report of an immunoglobulin E–mediated reaction to subcutaneous heparin at prophylactic dosing.

Clinical Findings: An 85-year-old male had a 3-year history of red meat allergy and was intolerant of pork and beef. He developed an immunoglobulin E–mediated allergic reaction to subcutaneous heparin at a dose of 5000 …

A Brief Literature Review On Heparin: To Bolus Or Not To Bolus, That Is The Question, Alex Gechlik, James Espinosa, Alan Lucerna, Kishan Patel

Rowan-Virtua Research Day

Heparin is an anticoagulant medication, used to inhibit the formation of thrombi that pose arteriolar and vein-occlusive risk. The choice between starting a heparin infusion with or without an initial bolus is case dependent based on whether a patient is already anticoagulated and if so, foregoing an initial bolus. In contrast, both anticoagulated and non-anticoagulated patients share the same goal when receiving Heparin for various thromboembolic syndromes, and that is to be within aPTT target range of 1.5-2.5 or 45 to 75 seconds. Falling below goal range leads to a 20-25% recurrence of VTE, and aPTT above goal range has …

Heparanase Blockade As A Novel Dual-Targeting Therapy For Covid-19, Jingyu Xiang, Mijia Lu, Min Shi, Xiaogang Cheng, Kristin A Kwakwa, Jennifer L Davis, Xinming Su, Suzanne J Bakewell, Yuexiu Zhang, Francesca Fontana, Yalin Xu, Deborah J Veis, John F Dipersio, Lee Ratner, Ralph D Sanderson, Alessandro Noseda, Shamim Mollah, Jianrong Li, Katherine N Weilbaecher

Open Access Publications

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused over 5 million deaths worldwide. Pneumonia and systemic inflammation contribute to its high mortality. Many viruses use heparan sulfate proteoglycans as coreceptors for viral entry, and heparanase (HPSE) is a known regulator of both viral entry and inflammatory cytokines. We evaluated the heparanase inhibitor Roneparstat, a modified heparin with minimum anticoagulant activity, in pathophysiology and therapy for COVID-19. We found that Roneparstat significantly decreased the infectivity of SARS-CoV-2, SARS-CoV-1, and retroviruses (human T-lymphotropic virus 1 [HTLV-1] and HIV-1)

Safety And Pharmacokinetics Of Intranasally Administered Heparin, Hannah M. Harris, Katherine L. Boyet, Hao Liu, Rohini Dwivedi

Faculty and Student Publications

Purpose: Intranasally administered unfractionated heparin (UFH) and other sulfated polysaccharides are potential prophylactics for COVID-19. The purpose of this research was to measure the safety and pharmacokinetics of clearance of intranasally administered UFH solution from the nasal cavity. Methods: Double-blinded daily intranasal dosing in C57Bl6 mice with four doses (60 ng to 60 μg) of UFH was carried out for fourteen consecutive days, with both blood coagulation measurements and subject adverse event monitoring. The pharmacokinetics of fluorescent-labeled UFH clearance from the nasal cavity were measured in mice by in vivo imaging. Intranasal UFH at 2000 U/day solution with nasal spray …

Saline Vs Heparin To Lock Central Lines And Effect On Line-Associated Complications: Summary, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Retrospective Evaluation Of Weight Based Heparin Protocol In Morbidly Obese Patients For The Treatment Of Venus Thromboembolism, Parth J. Patel, Brady Mcmahon, Christina Yang

Gulf Coast Division GME Research Day 2022

No abstract provided.

A Case Report Of A Patient On Therapeutic Warfarin Who Died Of Covid-19 Infection With A Sudden Rise In D-Dimer, Reita N. Agarwal, Hersheth Aggarwal, Ashmit Verma, Manish Tripathi

School of Medicine Publications and Presentations

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has disrupted social and economic life globally. The global pandemic COVID-19 caused by this novel SARS-CoV-2 shows variable clinical manifestations, complicated further by cytokine storm, co-infections, and coagulopathy, leading to severe cases and death. Thrombotic complications arise due to complex and unique interplay between coronaviruses and host cells, inflammatory response, and the coagulation system. Heparin and derivatives are World Health Organization (WHO) recommended anticoagulants for moderate and severe Corona Virus Disease 19 (COVID-19), that can also inhibit viral adhesion to the cell membrane by interfering with heparan sulfate-dependent binding to angiotensin-converting enzyme …

Research Visualization Of Different Treatment Modalities To Treat Covid-19 Infection: Bibliometric Analysis Of Pubmed Database, Abeel Naseer, Muhammad Shoaib, Nusrat Ali, Imtiaz Ahmad

Library Philosophy and Practice (e-journal)

This paper designed to examine research published in PubMed indexed journals of different treatment modalities to treat COVID -19 infection employing bibliometric analysis technique from 2020 to 2021. The purpose was to consolidate the published scholarly work in the PubMed database on different treatment modalities including vaccine, oxygen supplementation, dexamethasone or steroids, aspirin, heparin, remdesivir, zinc, vitamin c or ascorbic acid, oxygen, anti-malarial like chloroquine and hydroxychloroquine, and azithromycin or macrolides. We employed a bibliometric analysis technique and found a total of 3043 published documents. The study findings depicted that vaccine and COVID-19 top was at the top of the …

Evaluating The Efficacy Of A Nursing-Driven Versus Provider-Driven Heparin Protocol, Naman Upadhyay, Md, Joseph Soucy, Md, Steven Manobianco, Md, Samantha Sokoloff, Md, Sairamya Bodempudi, Md, Veda Pejaver, Md, Max Ruge, Md, Lynda Thomson, Pharmd, Lily Ackermann, Md

Health Equity and Quality Improvement (HEQI) Summit

At Thomas Jefferson University Hospital patients who require heparin infusions are monitored either by nursing alone or the resident and the nurse together.

This project aims to determine:

1. Which protocol more efficiently shortens the time to therapeutic?
2. Are patients therapeutic longer under a certain protocol?
3. Do more patients under either protocol suffer from bleeding complications?

Comparative Studies On Biochemical And Pharmacological Profiles Of Unfractionated Heparins & Their Depolymerized Derivatives From Bovine, Ovine And Porcine Origins, Ahmed Kouta

Dissertations

Heparin and heparin related drugs have remained the anticoagulant of choice for medical and surgical indications. These drugs are comprised of poly-component sulfated chains of varying length and biophysical structure with direct and indirect pharmacological effects. Heparins produce their therapeutic effects by multiple mechanisms involving both the cellular and humoral targets. These drugs represent natural products which are isolated from mammalian tissue rich in mast cells. Currently used heparin and LMWHs are obtained from porcine mucosal tissue. Other animal sources including bovine and ovine tissues also provide additional sources for the manufacturing of heparins. While there may be microchemical and …

Impact Of A Multidisciplinary Workflow On Safety And Management Of Patients With Heparin-Induced Thrombocytopenia, Sheh-Li Chen, Andrew P. Stivers, Jonathan D. Cicci, Tanner L. Hedrick, Marian A. Rollins-Raval, Raj S. Kasthuri, Kalynn A. Northam

Pathology Research and Scholarship

PURPOSE: Heparin-induced thrombocytopenia (HIT) is a serious complication of heparin administration. Management strategies are complex and include discontinuing heparin products, initiating alternative anticoagulants, interpreting laboratory test results, documenting heparin allergies, and providing patient education. Medication error reports and a retrospective review conducted at an academic medical center revealed an opportunity for a quality improvement initiative and led to the creation of a multidisciplinary workflow for the management of HIT. In a pre-post study, the impact of the multidisciplinary workflow on the safety and management of HIT was evaluated.

METHODS: The preimplementation group consisted of adult patients tested for suspected HIT …

Potential Perioperative Complications Due To Difference In Timing Of Systemic Heparinization During Ruptured Aneurysm Coiling, Rouzbeh Kotaki, Ameer E. Hassan, Wondwossen G. Tekle

MEDI 9331 Scholarly Activities Clinical Years

Potential Perioperative Complications Due To Differences in Timing Of Systemic Heparin Distribution During Ruptured Aneurysm Coiling

Introduction:

In general, systematic heparin anticoagulation is standard in regards to neurovascular intervention. When coiling ruptured aneurysms, many neurointerventionalists have their own protocol as to timing of systemic heparinization. There is ample research and literature reviewing the frequency of perioperative events, predictors and outcomes, as well as the efficacy in the use of anticoagulants and/or antiplatelets before, during, and after neurovascular procedures to prevent adverse outcomes. However, there currently exists a dearth of research in regards to timing of distribution of heparin intraoperatively and …

Comparison Of Standard Dose Vs Higher Dose Low Molecular Weight Heparin And Unfractionated Heparin For Dvt Prophylaxis In Covid-19 Patients, Zachary Brown Pharmd, Munyaradzi Chakabva Md, Tabinda Akhtar Md, Sarah Polina Pharmd, Bcps, Michael Todt Pharmd, Bcccp, Mckenna Brauner Np, Meghan Mcguire Np, Aws Polina Md

Parkview Pharmacy Department

2021 ASHP Midyear Clinical Meeting / Virtual / Poster # 1121810

Objective: To evaluate whether higher dose VTE prophylaxis results in a significant reduction in VTE events without significant increase in bleeding risk when compared to standard dose VTE prophylaxis in patients with COVID-19 infection

Impact Of Low Molecular Weight Heparin Administration On The Clinical Course Of Thecovid-19 Disease, Burcu Yormaz, Di̇lek Ergün, Baykal Tülek, Recai̇ Ergün, Uğur Arslan, Fi̇kret Kanat

Turkish Journal of Medical Sciences

Background: Lymphopenia is the most important criterion of mortality and discharging feature for patients infected with coronavirus disease 2019 (COVID-19). This study aimed to investigate the clinical impact of a low molecular weight heparin (LMWH) treatment on the clinical course of COVID-19. Materials and methods: Patients' clinical symptoms, radiologic outcomes, hematologic, biochemical, D-dimer, and C-reactive protein (CRP) results were obtained from their medical records. Participants were separated into 2 groups: one was treated with LMWH and the other was not. Improvement in the patients was compared before and after treatment. Results: Ninety-six patients who were diagnosed with COVID-19 between April …

Design Of Hfgf1 Variant(S) With Increased Stability And Enhanced Bioactivity, Shilpi P. Agrawal

Graduate Theses and Dissertations

Fibroblast growth factors (FGFs) are involved in various cellular processes such as cell growth,proliferation, differentiation, migration, angiogenesis, wound healing and embryonic development. Human acidic fibroblast growth factor (hFGF1) binds non-selectively to all the four FGF-receptors and is therefore considered as a powerful mitogen with broadest specificity. However, pharmacological applications of hFGF1 are restricted due to the low thermal stability of the growth factor. hFGF1 has low thermodynamic stability under physiological temperatures which leads to impairment of cellular signaling process thereby preventing its potential mitogenic properties. hFGF1 has a heparin binding pocket at the C-terminus which comprises of positively charges residues. …

Maternal Mortality Following Thromboembolism; Incidences And Prophylaxis Strategies., Mahboobeh Shirazi, Behrokh Sahebdel, Mehnoosh Torkzaban, Elham Feizabad, Marjan Ghaemi

Department of Radiology Faculty Papers

BACKGROUND: Thromboembolism is one of the main causes of maternal mortality, which can be prevented in many cases. The present study was designed to investigate the incidence and prophylaxis strategies for maternal mortality following thromboembolism in postnatal.

METHODS: In this case series study, the data of the mortality cases were extracted according to the ethical and security standards of the Ministry of Health of the country and compared with a healthy control group. The thromboembolism risk factors measured and scored using a questionnaire entitled "the evaluation of risk factors for maternal mortality following thromboembolism during pregnancy, labor, or post-partum".

RESULTS: …

Therapeutic Plasma Exchange And Intravenous Immune Globulin In The Treatment Of Heparin-Induced Thrombocytopenia: A Systematic Review, Chinonso Onuoha, Karen D. Barton, Edward C C Wong, Jay S. Raval, Marian A. Rollins-Raval, Tina A. Ipe, Joseph E. Kiss, Leonard I. Boral, Jill Adamksi, Nicole D. Zantek, Oluwatoyosi A. Onwuemene

Pathology Research and Scholarship

BACKGROUND: Immunomodulatory strategies in heparin-induced thrombocytopenia (HIT) include the use of intravenous immune globulin (IVIG) and therapeutic plasma exchange (TPE). The optimal application of these therapies is unknown and outcomes data are limited. We investigated treatment categories and laboratory and clinical outcomes of IVIG and/or TPE in HIT with a systematic literature review.

STUDY DESIGN AND METHODS: We searched MEDLINE, Embase, and Web of Science through December 2019 for studies combining controlled vocabulary and keywords related to thrombocytopenia, heparin, TPE, and IVIG. The primary outcome was treatment indication. Secondary outcomes were platelet recovery, HIT laboratory parameters, heparin re-exposure, and post-treatment …

Using Heparin-Coated Nanoparticles In The Treatment Of Neointimal Hyperplasia, Nardine M. Ghobrial

All Dissertations

The use of stents in the treatment of atherosclerosis leads to a potential risk of restenosis, caused by neointimal hyperplasia. Neointimal hyperplasia is mainly caused by an injury to the endothelial layer of the blood vessel followed by the proliferation of smooth muscle cells into the lumen of the blood vessel. To address this, we designed a magnetically-guided drug delivery system to locally deliver heparin to a stented artery. The nanoparticles were synthesized, characterized, and tested on relevant human cell lines.

The particles were non-toxic to human smooth muscle cells, endothelial cells, and fibroblasts. They reduced the proliferation of the …

Hyperkalemia Secondary To Prophylactic Heparin Use In A Trauma Patient: Case Report, Marco Custodio, Errington C. Thompson

Marshall Journal of Medicine

This case report describes a complex trauma patient who develops hyperkalemia secondary to heparin. Heparin is a commonly used drug in trauma patients. Physicians need to be aware of this potentially harmful adverse reaction in these high-risk patients.

Single Center Study Of The Impella Pump, Supraja Thunuguntla, Charles F. Mild

School of Medicine Publications and Presentations

Background:

Impella® is a percutaneously inserted ventricular assist device. Its use increased from 11 devices placed in 2016 to 39 in 2019 at Valley Baptist Medical Center (VBMC). We review the anticoagulation options, side effects, and mortality.

Method:

Retrospective chart review of 107 patients placed on Impella from 2016-2020 admitted to VBMC. Descriptive statistics were used to assess the distribution of variables; continuous variables summarized as mean values with standard deviations and categorical variables as counts/percentages.

Results:

Indication for Impella was protected percutaneous coronary intervention (PCI) (71%, of which 18.4% was intervention on a previous coronary artery bypass graft, CABG), …