Thrombin generation in plasma from patients with cirrhosis supplemented with normal plasma: considerations on the efficacy of treatment with fresh-frozen plasma.


:Cirrhosis is characterized by a complex coagulation defect leading to the prolongation of the prothrombin and activated partial thromboplastin times (PT and APTT). Arbitrary PT cut-off values are still used as a yardstick to guide treatment with fresh-frozen plasma (FFP) or other pro-coagulant agents in patients undergoing invasive procedures. No randomized studies on the FFP efficacy are available, and are unlikely to be carried out because of their complex organization. An interim solution could be to evaluate the in vitro thrombin generation in plasmas from patients with cirrhosis when mixed with appropriate amounts of pooled normal plasma (PNP). The PT, APTT and thrombin generations in the presence of thrombomodulin were examined in 58 patients with cirrhosis and 24 healthy subjects both before and after mixing their plasmas with PNP at a proportion of 4 + 1 (patient + PNP), chosen to mimic in vivo conditions when patients are treated with 10 ml/kg of FFP. The PT and APTT, which were abnormal in the majority of unmixed patient plasmas were shortened considerably, but did not normalize completely when mixed with PNP. Thrombin generation, which was already within normal limits in all unmixed patient plasmas, remained essentially unchanged after mixing with PNP. In conclusion, thrombin generation in patients with cirrhosis does not appreciably change after in vitro addition of PNP despite PT and APTT shortening would suggest otherwise. These results question the validity of the PT as a stand-alone test to guide transfusion of FFP in the setting of chronic liver disease.


Intern Emerg Med


Tripodi A,Chantarangkul V,Primignani M,Clerici M,Dell'era A,Aghemo A,Mannucci PM




Has Abstract


2012-04-01 00:00:00












  • Relation between admission serum potassium levels and long-term mortality in acute coronary syndrome.

    abstract::Serum potassium homeostasis play an important role in myocardial function, but the impact of serum potassium levels on long-term mortality has not been well evaluated. In the current study, we investigated patients with acute coronary syndrome (ACS) and analyzed the relationship between admission serum potassium level...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Peng Y,Huang FY,Liu W,Zhang C,Zhao ZG,Huang BT,Liao YB,Li Q,Chai H,Luo XL,Ren X,Chen C,Meng QT,Huang DJ,Wang H,Chen M

    更新日期:2015-12-01 00:00:00

  • Echocardiographic assessment of the right ventricle in COVID -related acute respiratory syndrome.

    abstract::In patients with the novel coronavirus (COVID-19) infection, the echocardiographic assessment of the right ventricle (RV) represents a pivotal element in the understanding of current disease status and in monitoring disease progression. The present manuscript is aimed at specifically describing the echocardiographic a...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Lazzeri C,Bonizzoli M,Batacchi S,Peris A

    更新日期:2021-01-01 00:00:00

  • Cardiometabolic risk prevention strategies: the importance of sharing experiences between Mediterranean countries.

    abstract::According to the Global Burden of Disease Study 2017, between 1990 and 2017, Italy experienced a more attenuate reduction in cardiovascular deaths than Western Europe. When considering risk factors, our Country experienced a reduction in the prevalence of hypertension in the last few decades, especially in women. On t...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: Modesti PA,Jarraya F,Mascherini G,Perticone F

    更新日期:2020-06-01 00:00:00

  • The effect of management models on thromboembolic and bleeding rates in anticoagulated patients: an ecological study.

    abstract::The primary study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible ...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Tosetto A,Testa S,Palareti G,Paoletti O,Nichele I,Catalano F,Morandini R,Di Paolo M,Tala M,Esteban P,Cora' F,Mannino S,Maroni A,Sessa M,Castaman G

    更新日期:2019-11-01 00:00:00

  • Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications.

    abstract::The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Hypes C,Sakles J,Joshi R,Greenberg J,Natt B,Malo J,Bloom J,Chopra H,Mosier J

    更新日期:2017-12-01 00:00:00

  • The perception of health-related quality of life in colon cancer patients during chemotherapy: differences between men and women.

    abstract::There is a need for more information on the quality of life (QoL) in patients undergoing chemotherapy. We wanted to investigate the perception of health status in colon cancer patients before, 3 and 6 months after chemotherapy. A secondary purpose was to assess the different perceptions of QoL between men and women du...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Domati F,Luppi G,Reggiani-Bonetti L,Zironi S,Depenni R,Fontana A,Gelsomino F,de Leon MP

    更新日期:2015-06-01 00:00:00

  • Colchicine is safe and effective for secondary prevention of recurrent pericarditis.

    abstract::The CORP (COlchicine for Recurrent Pericarditis) trial [7]is a prospective, randomized, double-blind, placebo controlled, multicenter trial to evaluate the efficacy and safety of colchicine (1.0–2.0 mg on the first day, followed by a maintenance dose of 0.5–1.0 mg/day for 6 months) in association with conventional ant...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gianni F,Solbiati M,Gruppo di Autoformazione Metodologica (GrAM).

    更新日期:2012-04-01 00:00:00

  • Splanchnic vein thrombosis: clinical presentation, risk factors and treatment.

    abstract::The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS), extrahepatic portal vein obstruction (EHPVO), and mesenteric vein thrombosis; the simultaneous involvement of additional regions is frequent, and clinical presentations and risk factors may be shared. The annual incidence of BCS and isolated m...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: De Stefano V,Martinelli I

    更新日期:2010-12-01 00:00:00

  • Clinical impact of application of risk assessment models (Padua Prediction Score and Improve Bleeding Score) on venous thromboembolism, major hemorrhage and health expenditure associated with pharmacologic VTE prophylaxis: a "real life" prospective and re

    abstract::International guidelines recommend the use of pharmacological prophylaxis in hospitalized medical patients at high risk of venous thromboembolism (VTE). The same international guidelines suggest the employment of standardized risk assessment models (RAMs) when evaluating the administration of pharmacological prophylax...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Depietri L,Marietta M,Scarlini S,Marcacci M,Corradini E,Pietrangelo A,Ventura P

    更新日期:2018-06-01 00:00:00

  • Prevalence and 1-year prognosis of transient heart failure following coronary revascularization.

    abstract::The occurrence of heart failure during the whole pre-discharge course of coronary revascularization, as far as its influence on subsequent prognosis, is poorly understood. The present study examined the effect of transient heart failure (THF) developing in the acute and rehabilitative phase on survival after coronary ...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,多中心研究


    authors: Ambrosetti M,Griffo R,Tramarin R,Fattirolli F,Temporelli PL,Faggiano P,De Feo S,Vestri AR,Giallauria F,Greco C

    更新日期:2014-09-01 00:00:00

  • Italian intersociety consensus on DOAC use in internal medicine.

    abstract::The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, a...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Prisco D,Ageno W,Becattini C,D'Angelo A,Davì G,De Cristofaro R,Dentali F,Di Minno G,Falanga A,Gussoni G,Masotti L,Palareti G,Pignatelli P,Santi RM,Santilli F,Silingardi M,Tufano A,Violi F,SIMI (Italian Society of Inte

    更新日期:2017-04-01 00:00:00

  • Errors in medical literature: not a question of impact.

    abstract::The editorial and peer-review processes should guarantee readers as to the reliability of published data. The first step of these processes is to check for errors. The aim of our study was to look for the presence of objective errors in consecutive articles published on three of the most authoritative clinical journal...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Costantino G,Casazza G,Cernuschi G,Solbiati M,Birocchi S,Ceriani E,Duca P,Montano N

    更新日期:2013-03-01 00:00:00

  • The management of patients with venous thromboembolism in Italy: insights from the PREFER in VTE registry.

    abstract::Venous thromboembolism (VTE) is the third most common cardiovascular disease. Real-life data on the clinical presentation, risk factors, diagnosis, and treatment of VTE in Italy and Europe are required to optimize the management of this disease. The PREFER in VTE registry, a prospective non-interventional real-life st...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Guercini F,Mommi V,Camporese G,Tonello C,Imberti D,Benedetti R,De Bartolomeo G,Di Lecce L,Romeo F,Agnelli G

    更新日期:2016-12-01 00:00:00

  • The prognostic role of gamma-glutamyltransferase activity in non-diabetic ST-elevation myocardial infarction.

    abstract::In patients with acute coronary syndrome, gamma-glutamyltransferase activity (GGT) proved to be an independent predictor of the development of major adverse cardiac events at early and long terms. No data are available on GGT in ST-elevation myocardial infarction (STEMI). We assessed, in 337 consecutive STEMI patients...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Lazzeri C,Valente S,Tarquini R,Chiostri M,Picariello C,Gensini GF

    更新日期:2011-06-01 00:00:00

  • Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry.

    abstract::The objective of this study is to determine the prevalence of cognitive impairment (CogI) in patients hospitalized for congestive heart failure, and the influence of CogI on mortality and hospital readmission. This is a multicenter cohort study of patients hospitalized for congestive heart failure enrolled in the RICA...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: García Bruñén JM,Povar Echeverria M,Díez-Manglano J,Manzano L,Trullàs JC,Romero Requena JM,Salamanca Bautista MP,González Franco Á,Cepeda Rodrigo JM,Montero-Pérez-Barquero M,RICA Investigators Group.

    更新日期:2021-01-01 00:00:00

  • Recent advances in understanding ulcerative colitis.

    abstract::Ulcerative colitis, one of the two main forms of inflammatory bowel disease, is characterized by inflammation of the large bowel with constant involvement of the rectum, and a possible continuous retrograde distribution up to the cecum. Typical macroscopic lesions are mucosal ulcerations, with immune cell infiltration...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: Di Sabatino A,Biancheri P,Rovedatti L,Macdonald TT,Corazza GR

    更新日期:2012-04-01 00:00:00

  • Effects of cryoablation and radiofrequency ablation on endothelial and blood clotting activation.

    abstract::Cryoablation (CA) emerged as an alternative procedure to radiofrequency (RF). The aim of this study was to compare haemostatic system alterations in patients undergoing RF or CA for atrioventricular nodal reentrant tachycardia ablation. von Willebrand factor (vWF), spontaneous whole blood platelet aggregation, prothro...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Pieragnoli P,Gori AM,Ricciardi G,Carrassa G,Checchi L,Michelucci A,Priora R,Cellai AP,Marcucci R,Padeletti L,Abbate R

    更新日期:2014-12-01 00:00:00

  • Which method is best for an early accurate diagnosis of acute heart failure? Comparison between lung ultrasound, chest X-ray and NT pro-BNP performance: a prospective study.

    abstract::Acute heart failure is a common condition among adults presenting with dyspnea in the Emergency Department (ED), still the diagnosis is challenging as objective standardized criteria are lacking. First line work-up, other then clinical findings, is nowadays made with lung ultrasound imaging study, chest X-ray study an...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Sartini S,Frizzi J,Borselli M,Sarcoli E,Granai C,Gialli V,Cevenini G,Guazzi G,Bruni F,Gonnelli S,Pastorelli M

    更新日期:2017-09-01 00:00:00

  • Impact of gender on short-term and long-term all-cause mortality in patients with non-ST-segment elevation acute coronary syndromes: a meta-analysis.

    abstract::A meta-analysis to determine the impact of gender on mortality in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS): PubMed, EMBASE, and Cochrane Library, was systematically searched. Two investigators independently reviewed retrieved articles and assessed eligibility. Unadjusted mortality rat...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,meta分析,评审


    authors: Wang Y,Zhu S,Du R,Zhou J,Chen Y,Zhang Q

    更新日期:2018-03-01 00:00:00

  • An Italian version of the Ottawa Crisis Resource Management Global Rating Scale: a reliable and valid tool for assessment of simulation performance.

    abstract::Objective measurement of simulation performance requires a validated and reliable tool. However, no published Italian language assessment tool is available. Translation of a published English language tool, the Ottawa Crisis Resource Management Global Rating Scale (GRS), may lead to a validated and reliable tool. Afte...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Franc JM,Verde M,Gallardo AR,Carenzo L,Ingrassia PL

    更新日期:2017-08-01 00:00:00

  • Six minute walk test: a simple and useful test to evaluate functional capacity in patients with heart failure.

    abstract::In heart failure survival is closely related to functional capacity. Peak O2 consumption at cardiopulmonary exercise test (CPET) is considered the gold standard for the evaluation of exercise tolerance. Since >70% of patients with heart failure, usually elderly or with significant comorbidities, are referred to Depart...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: Rostagno C,Gensini GF

    更新日期:2008-09-01 00:00:00

  • Clinical characteristics and outcomes of patients with extended-spectrum β-lactamase-producing bacteremias in the emergency department.

    abstract::Extended-spectrum β-lactamase (ESBL)-producing bacteria have been spreading from hospitals to communities. Despite this, there are limited emergency department (ED) patient-based studies about these bacteremias. A retrospective matched case-control study with a ratio of 1:3 was conducted at a university hospital. The ...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Lin JN,Chen YH,Chang LL,Lai CH,Lin HL,Lin HH

    更新日期:2011-12-01 00:00:00

  • Author Correction: Toxic alcohol diagnosis and management: an emergency medicine review.

    abstract::Toxic alcohols are a group of substances containing a hydroxyl group not meant to be ingested. They are the cause of a significant number of accidental and non-accidental exposures. Toxic alcohol poisoning can be associated with a significant degree of morbidity and mortality if not promptly recognized and treated. Th...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,已发布勘误


    authors: Ng PC,Long BJ,Davis WT,Sessions DJ,Koyfman A

    更新日期:2018-08-01 00:00:00

  • NIV by an interdisciplinary respiratory care team in severe respiratory failure in the emergency department limited to day time hours.

    abstract::Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) wo...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Horvath CM,Brutsche MH,Schoch OD,Schillig B,Baty F,vonOw D,Rüdiger JJ

    更新日期:2017-12-01 00:00:00

  • Prevalence and prognostic impact of left ventricular non-compaction in patients with thalassemia.

    abstract::A high incidence of isolated left ventricular non-compaction (LVNC) has been reported in previous studies on smaller cohorts of patients with thalassemia by cardiac MRI but the clinical impact of the finding is unknown. This prospective cohort study evaluates the prevalence and clinical implication of the finding. Pro...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Bonamini R,Imazio M,Faletti R,Gatti M,Xhyheri B,Limone M,Longo F,Piga A

    更新日期:2019-11-01 00:00:00

  • Anticoagulant therapy in the treatment of splanchnic vein thrombosis associated to acute pancreatitis: a 3-year single-centre experience.

    abstract::Splanchnic vein thrombosis (SVT) is a possible complication of acute pancreatitis (AP). There are no precise guidelines on the use of anticoagulant therapy (AT) in these patients. The aim of the study was to determine the safety and the efficacy of AT in AP-associated SVT. Two hundred twenty-one patients were retrospe...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Pagliari D,Cianci R,Brizi MG,Mancarella FA,Musso M,Cintoni M,Franza L,Flore RA,Gasbarrini A,Tondi P

    更新日期:2020-09-01 00:00:00

  • Inflammatory biomarkers and coronary heart disease: from bench to bedside and back.

    abstract::Inflammation plays a pivotal role in all stages of atherosclerosis from endothelial dysfunction and plaque formation to plaque destabilization and disruption. Inflammatory biomarkers, originally studied to better understand the pathophysiology of atherosclerosis, have generated increasing interest among clinicians, be...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: Biasillo G,Leo M,Della Bona R,Biasucci LM

    更新日期:2010-06-01 00:00:00

  • Cardiovascular oncology: a new discipline inside internal medicine?

    abstract::Cardiovascular disease and cancer incidence and prevalence have risen over the past few decades to become the leading causes of death. On the one hand, cancer patients will be treated with cardiotoxic chemotherapies; on the other, cardiovascular patients will receive a new diagnosis of cancer and will have to face tre...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: Prisco D,D'Elios MM,Cenci C,Ciucciarelli L,Tamburini C

    更新日期:2014-06-01 00:00:00

  • Prevention of anthracycline-induced cardiotoxicity: a systematic review and meta-analysis.

    abstract::Anthracyclines are extensively used in oncologic patients, in particular for breast cancer and hematological malignancies. Cardiac injury is a potentially dangerous side effect of these drugs. In this systematic review, we analyzed published randomized controlled trials (RCTs) to assess if potential cardioprotective d...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章,评审


    authors: Caspani F,Tralongo AC,Campiotti L,Asteggiano R,Guasti L,Squizzato A

    更新日期:2020-10-03 00:00:00

  • Management of patients with chronic heart failure and type 2 diabetes mellitus: the SCODIAC-II study.

    abstract::SCODIAC was a pilot study which revealed an increasing use of SGLT2i in 123 outpatients affected with Heart Failure (HF) and Type 2 Diabetes Mellitus. SCODIAC-II study, the second phase of the program, has been carried out to determine diagnostic and therapeutic pathways in a larger group of patients and to verify whe...

    journal_title:Internal and emergency medicine

    pub_type: 杂志文章


    authors: De Luca M,Bosso G,Valvano A,Guardasole V,Botta A,Carbone V,Carella G,Del Buono A,Di Giovanni G,Fimiani B,Guarnaccia F,Lapice E,Martedì E,Memoli G,Oliva D,Romano G,Cittadini A,Zito GB,Oliviero U

    更新日期:2020-10-17 00:00:00