Methods. PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched for clinical studies evaluating nonoperative methods of treating discogenic back pain that were published between 2000 and 2012. Only prospective randomized controlled studies that compared a nonsurgical intervention with sham or placebo therapy were included. After removal of duplicate citations, a total of 226
articles were initially identified from the search terms. From these, we identified 11 randomized https://www.selleckchem.com/products/sc79.html controlled trials (RCTs) from which data analysis was performed. Results. The 11 RCTs investigated traction therapy, injections, and ablative techniques. Results from 5 RCTs investigating methylene blue injection, steroid injection, ramus communicans ablation, intradiscal electrothermal therapy, and biacuplasty favored intervention over sham therapy. However, results from the study on methylene blue injections have not been replicated in other RCTs. Evaluation of the selection criteria used in the studies on ramus communicans ablation and intradiscal biacuplasty and a stratified analysis of results from the RCTs on intradiscal electrothermal therapy casts doubt on whether
the conclusions from these RCTs can be applied to the general patient population with discogenic pain. Conclusion. There are few high-quality studies evaluating nonoperative treatments for reducing discogenic low back pain. Although conclusions from several studies favor intervention over sham, it Selleck AZD5153 is unclear whether see more these interventions
confer stable long-term benefit. There is some promise in newer modalities such as biacuplasty; however, more inclusive studies need to be performed.”
“In anaerobic processes, the population dynamics of methanogens in the methanogenic stage were monitored along with hydraulic retention times (HRTs) shift. Decreasing HRTs increased the loading rates of volatile fatty acids (VFAs) and ammonia. Methanomicrobiales (MMB) began to be dominant at longer than 12.5 days HRT, Methanosarcinales (MSL) were dominant at 8, 10, and 12.5 days HRT, and Methanobacteriales (MBT) were dominant at shorter than 6 days HRT. Increased loading rates of VFAs and ammonia increased MBT, decreased MMB, and had no significant effect on MSL. Maximal daily methane production was observed at 1.57 L/L when MSL copy numbers also reached 3.60 x 10(7) copy/mL as a peak, which were expressed as positive correlation between DMA and MSL. No sooner had methane yield (MY) increased from 1.15 to 1.32 L/g VSremoved along with HRT reduction from 25 to 22.5 days, then MY gradually decreased from 1.32 to 0.04 L/g VSremoved.”
“Objectives: To investigate differences in the gingival crevicular fluid (GCF) composition between adolescent and adult patients undergoing orthodontic treatment with fixed appliances. Materials and Methods: Ten adolescents (14.4 +/- 1.43) and 10 adults (28.5 +/- 7.83) with Class I malocclusions and minor upper incisor crowding were allocated to two different age groups.
(C) 2013 Elsevier Ltd. All rights reserved.”
“Peripheral T/NK-cell lymphomas (PTCL) are rare malignancies with a poor prognosis. Due to the lack of randomised studies, standard therapy has not been established. First-line treatment with
anthracycline-based polychemotherapy followed by consolidation with high-dose therapy and autologous stem cell transplant in responding patients has demonstrated good feasibility with low toxicity in prospective studies Ricolinostat mouse and is widely used in eligible patients. In relapsed and refractory patients, who are not candidates for transplant approaches, therapeutic options are limited and are usually palliative. Several new agents are currently under investigation to improve the outcome of PTCL in the first line and salvage settings. Belinostat, a histone deacetylase (HDAC) inhibitor, has demonstrated broad antineoplastic activity in preclinical studies, and promising results in advanced relapsed/refractory lymphomas. Here, we report the case of a 73 year old patient with heavily pre-treated refractory PTCL in complete remission with belinostat for 39 months.”
“OBJECTIVES: Functional dyspepsia (FD) is a common condition in the general population; however, its treatment remains a challenge. The aim of this study was to examine the efficacy of tandospirone citrate, a new partial agonist of the
5-hydroxytryptamine 1A (5-HT1A) receptor, in improving the symptoms of patients with Salubrinal nmr FD.\n\nMETHODS: In LEE011 manufacturer this double-blind, placebo-controlled, multicenter study, FD patients were randomized to treatment with 10 mg t.i.d. tandospirone citrate or to placebo for 4 weeks. The primary end point was change in abdominal symptom scores. The difference in the proportion of responders (a total abdominal symptom score of 0 or 1) was also assessed. The quality-of-life questionnaire, the SF-8, and a psychological test questionnaire, the State-Trait Anxiety Inventory (STAI), were completed at baseline and at weekly intervals.\n\nRESULTS: Data were available for 144 patients: 73 for tandospirone and 71 for placebo. Improvements
in total abdominal scores were significantly larger with tandospirone than placebo at weeks 1, 2, and 4. Significantly greater improvements in the tandospirone group were observed in upper abdominal pain (P = 0.02) and discomfort (P = 0.002) at week 4. The proportion of responders was significantly greater in the active treatment arm at weeks 3 (P = 0.017) and 4 (P = 0.0016). Significant improvements in STAI (P < 0.0001) were reported in both arms, as well as in the majority of questions in the SF-8 (P = 0.04). No serious adverse events were reported, with similar rates in both study arms.\n\nCONCLUSIONS: Despite a considerable placebo effect, the benefits of tandospirone were shown in terms of improvement in abdominal symptom scores.
“This study was conducted to investigate the optimum storage temperature and the effect of 1-methylcyclopropene (1-MCP) on the postharvest physiology and quality of plumcot (Prunus salicina Lindle. x Prunus armeniaca L.) ‘Harmony’ fruits. plumcot fruits were find more stored at 0, 5, 10, and 20 degrees C, respectively, with three different ripeness stages grouped by skin color development. Furthermore, we treated 1 mu L-L-1 1-MCP was treated at 10 degrees C for 17 hours and stored at 10 degrees C for 12 days to evaluate the effectiveness for better shelf-life. The results indicated that lower storage temperature than room temperature effectively
reduced the respiration rate with delaying quality changes. While, the fruits showed worse fruit taste than the fruits stored at 10 and 20 degrees C. Reversely, the fruits stored at 20 degrees C showed more respiration rate and ethylene production. 1-MCP treatment effectively reduced the skin red color development, ethylene production, CO2 and softening of plumcot ‘Harmony’
fruits. Overall data indicated that the optimum harvest time and storage GW4869 concentration temperature could be 30-50% red color and near 10 degrees C. Postharvest 1-MCP application at the level of 1.0 mu L.L-1 could maintain fruit quality well in plumcot fruits.”
“Although the regulation of membrane receptor activation is known to be crucial for molecular signal transduction, the molecular mechanism Caspase activity assay underlying receptor activation is not fully elucidated. Here we study the physicochemical nature of membrane receptor behavior by investigating the characteristic molecular vibrations of receptor ligands using computational chemistry and informatics methods. By using information gain, t-tests, and support vector machines, we have identified highly informative features of adenosine receptor (AdoR) ligand and corresponding functional amino acid residues such as Asn (6.55) of AdoR that has informative significance and is
indispensable for ligand recognition of AdoRs. These findings may provide new perspectives and insights into the fundamental mechanism of class A G protein-coupled receptor activation. (C) 2015 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.”
“Eucalyptus saligna is an important woody plant used to lumber and cellulose. The aim of this research was to establish a protocol for micropropagation of this species from cotyledonary nodes. Plantlets with 16 days old were used as a donor explants. The induction of cotyledonary nodes consisted of two parts: a dark culture followed by a light culture. Basal medium was MS added with 30g.L-1 sucrose, 10% coconut water and solidified with 7g.L-1 agar. For the dark culture the media were supplemented with 3.6 mu M NAA (Naftalenoacetic acid) and 4.
During reproductive aging in female rats, there is a loss of GnRH pulses and a diminution of the GnRH surge. However, information about the specific role of GnRH nerve terminals is lacking, selleck screening library particularly in the context of aging. We sought to gain novel ultrastructural information about GnRH neuroterminals
by performing three-dimensional (3D) reconstructions of GnRH neuroterminals and their surrounding microenvironment in the median eminence of young (4-5 months) and old (22-24 months) ovariectomized Sprague-Dawley female rats. Median eminence tissues were freeze-plunge embedded and serial ultrathin sections were collected on slot grids for immunogold labeling of GnRH immunoreactivity. Sequential images were used to create 3D models of GnRH terminals. These reconstructions provided novel perspectives into the morphological properties of GnRH terminals and their neural and glial environment. We also noted that the cytoarchitectural features of the median eminence became disorganized with aging. Quantitative measures showed a significant decrease in the apposition between GnRH terminal membranes and glial cells. Our data suggest reproductive aging in rats is characterized by structural organizational changes to the GnRH terminal microenvironment in the median eminence. J. Comp. Neurol. 517:284-295, 2009. (C) 2009 Wiley-Liss,
“Vaccines have been a cornerstone in medicine and public health Tariquidar inhibitor since their inception in the 18(th) century by Edward Jenner. Today, greater than 20 vaccines are used worldwide for the prevention of both viral and bacterial diseases. This article will review the vaccines used for the following dermatological diseases: smallpox, measles, mumps, rubella, chickenpox, shingles, and human papillomavirus.”
“Cytogenetic studies have demonstrated that duplications SB273005 in vitro or deletions of entire chromosomes or microscopically visible aberrations are associated with specific congenital disorders. The subsequent development and application of microarray-based assays
have established the importance of copy number variants (CNV) as a substantial source of genetic diversity in the human genome. Pathogenic CNVs are associated not only with birth defects and cancers, but also with neurodevelopmental disorders at birth or neurodegenerative diseases in adulthood. Unfortunately, the limited knowledge of the phenotypic effects of most CNVs has led to the classification of many CNVs as genomic imbalances of unknown clinical significance. This has caused many clinicians to resist the introduction of microarray technologies in detecting CNVs in a genome-wide manner for prenatal applications. This review summarises our current understanding of CNVs, the common detection methods, and the implications for human health and prenatal diagnosis.”
“Acorn barnacles are important model organisms for the study of sex allocation.
0 ng/mL vs 551.5 ng/mL, respectively, p smaller than 0.01). There was no significant difference between groups in transferrin saturation, erythrocyte zinc protoporphyrin concentration, hemoglobin concentration, or packed RBC transfusion requirement. There was no significant difference between groups in the risk of infection, length of stay, or mortality. Conclusions: Iron supplementation increased the serum ferritin concentration significantly, but it had no discernible effect on transferrin saturation, iron-deficient erythropoiesis,
hemoglobin concentration, or packed RBC transfusion requirement. Based on these data, routine IV iron supplementation of anemic, critically ill trauma patients cannot be recommended (NCT 01180894).”
“The 1,2-propanediol (1,2-PD) Selleck MEK inhibitor inducible membrane-bound l-pantoyl lactone (l-PL) dehydrogenase (LPLDH) has been isolated from Rhodococcus erythropolis AKU2103 (Kataoka et al. in Eur J Biochem 204:799, 1992). Based on the N-terminal amino acid sequence of LPLDH and the highly conserved amino acid sequence in homology search results, the LPLDH gene (lpldh) was cloned. The gene consists of 1,179 bases and encodes a protein of 392 amino acid residues. The deduced amino acid sequence showed high Selleckchem Proteasome inhibitor similarity to the proteins of the FMN-dependent alpha-hydroxy acid dehydrogenase/oxidase family.
The overexpression vector pKLPLDH containing lpldh with its upstream region (1,940 bp) was constructed and introduced into R. erythropolis AKU2103. The recombinant R. erythropolis AKU2103 harboring pKLPLDH showed six times higher LPLDH activity than the wild-type strain. LXH254 research buy Conversion of l-PL to ketopantoyl lactone was achieved with 92% or 80% conversion yield when the substrate concentration was 0.768 or 1.15 M, respectively. Stereoinversion of l-PL to d-PL was also carried out by using the combination of recombinant R. erythropolis AKU2103 harboring pKLPLDH and ketopantoic acid-reducing Escherichia coli.”
“A recent associative model (Miller, N.Y., & Shettleworth, S.J., 2007. Learning about environmental geometry: An associative model. Journal
of Experimental Psychology: Animal Behavior Processes B, 33, 191-212) is an influential mathematical account of how agents behave when reorienting to previously learned locations in spatial arenas. However, it is mathematically and empirically flawed. The current article explores these flaws, including its inability to properly predict geometric superconditioning. We trace the flaws to the model’s mathematical structure and how it handles inhibition. We then propose an operant artificial neural network model that solves these problems with inhibition and can correctly model both reorientation and superconditioning.”
“Discovery of tumor antigen (TA) recognized by autologous T cells (TCs) in patients with melanoma has led to clinical protocols using either vaccination or adoptive transfer of TA-specific TCs.
This result shows that cinnamon oil could successfully replace the use of methylparaben in cosmetics, at the same time ensuring microbiological purity of a cosmetic product under its in-use and storage conditions.”
“Background information. Intestinal absorption of alimentary lipids is a complex process ensured by enterocytes and leading to TRL [TAG (triacylglycerol)-rich lipoprotein] assembly and secretion. The accumulation of circulating intestine-derived TRL is associated with atherosclerosis, stressing the importance of the control of postprandial
hypertriglyceridaemia. During the postprandial period, TAGs are also transiently stored as CLDs (cytosolic lipid droplets) in enterocytes.
As a first step for determining whether CLDs could play a role in the control of enterocyte TRL secretion, we analysed the protein endowment PP2 order of CLDs isolated by sucrose-gradient centrifugation from differentiated Caco-2/TC7 enterocytes, the only human model able to secrete TRL in culture and to store transiently TAGs as CLDs when supplied with lipids. Cells were analysed after a 24 h incubation with lipid micelles and thus in a state of CLD-associated TAG mobilization.\n\nResults. Among the 105 proteins identified in the CLD fraction by LC-MS/MS (liquid chromatography coupled with tandem MS), 27 were directly involved in lipid metabolism pathways potentially relevant to enterocyte-specific functions. The transient feature of CLDs was consistent with WH-4-023 ic50 the presence of proteins necessary for fatty acid activation (acyl-CoA synthetases) and for TAG hydrolysis. HSP990 price In differentiated Caco-2/TC7 enterocytes, we identified for the first time LPCAT2
(lysophosphatidylcholine acyltransferase 2), involved in PC (phosphatidylcholine) synthesis, and 3BHS1 (3-beta-hydroxysteroid dehydrogenase 1), involved in steroid metabolism, and confirmed their partial CLD localization by immunofluorescence. In enterocytes, LPCAT2 may provide an economical source of PC, necessary for membrane synthesis and lipoprotein assembly, from the lysoPC present in the intestinal lumen. We also identified proteins involved in lipoprotein metabolism, such as ApoA-IV (apolipoprotein A-IV), which is specifically expressed by enterocytes and has been proposed to play many functions in vivo, including the formation of lipoproteins and the control of their size. The association of ApoA-IV with CLD was confirmed by confocal and immunoelectron microscopy and validated in vivo in the jejunum of mice fed with a high-fat diet.\n\nConclusions. We report for the first time the protein endowment of Caco-2/TC7 enterocyte CLDs. Our results suggest that their formation and mobilization may participate in the control of enterocyte TRL secretion in a cell-specific manner.
It was found that under the investigated conditions in electrospinning of polylactic acid (PLA) melt, air drag produced an additional 10% thinning compared to the un-assisted melt electrospinning process, and the heating provided by the air stream resulted in an additional 20-fold jet thinning. (C) 2010 Elsevier Ltd. All rights reserved.”
“In this article, the authors demonstrate that the use of relative weights, as incorporated within the National Quality Forum-endorsed PacifiCare readmission measure, is inappropriate for risk adjusting rates of hospital readmission.”
“Purpose: Post-traumatic oromandibular
dystonia (PTOD) is a disorder whose symptoms can include bruxism, muscle pain, and involuntary muscle contraction, among others. The use of onabotulinumtoxinA (ObT-A) is helpful in controlling the symptoms of patients with PTOD. The aim of this Bafilomycin A1 order study was to evaluate the use of ObT-A in the treatment of PTOD. ICG-001 cell line Materials and Methods: In this prospective case-series study, the population consisted exclusively of patients diagnosed with PTOD, without distinction by age or gender, from January 2007 to December 2010. The patients were diagnosed with PTOD and treated with ObT-A infiltration (primary predictor) at the Department of Maxillofacial Surgery at the Hospital Clinico Mutual de Seguridad (Santiago,
Chile). The primary outcome variables were bruxism, muscle pain, and involuntary muscle contraction. The data were obtained through questionnaires registered in tables at each control. Systat 13.1 was used for statistical analysis. The statistical test used to compare patients’ evolution over time was the test of signs. Results: Thirty male patients 18 to 65 years old diagnosed with PTOD were treated with ObT-A infiltrations. selleck inhibitor The signs and symptoms associated with oromandibular dystonia (bruxism, muscle pain, and involuntary muscle contraction) were decreased in all patients after ObT-A infiltrations. Conclusions: The positive results and the absence of complications recommend the use of the infiltration protocol
presented in this study for the treatment of PTOD. (C) 2015 American Association of Oral and Maxillofacial Surgeons”
“Coeliac disease is a common and important gastrointestinal disease. It affects at least 1%, most Western European populations and in Nordic countries it is even more frequent. It is strongly associated with certain Human Leukocyte Antigen-DQ genes and triggered by ingestion of wheat gluten and related cereals from rye and barley. The diagnosis relies on a combination of clinical signs, serology and small intestinal biopsy. Work during the last couple of decades has shown that gluten-specific, Human Leukocyte Antigen-DQ-restricted T-cells in the intestinal mucosa are of paramount importance in the disease process.
“The high degree of specificity displayed by antibodies often results in varying potencies against antigen orthologs, which can affect the efficacy of these molecules in different animal models of disease. We have used a computational design strategy to improve the species cross-reactivity of an antibody-based inhibitor of the cancer-associated serine protease
MT-SP1. In silico predictions were tested in vitro, and the most effective mutation, T98R, was shown to improve antibody affinity for the mouse ortholog of the enzyme 14-fold, resulting in an inhibitor with a K(I) of 340 pM. This improved affinity will be valuable when exploring the role of MT-SP1 in mouse models of cancer, and the strategy
outlined here could be useful in fine-tuning antibody specificity. (C) 2009 AG-014699 research buy Elsevier Ltd. All rights reserved.”
“Duplications of the long arm of the X chromosome are rare. The infantile phenotype shares some resemblance with the Prader-Willi syndrome, presenting severe psychomotor retardation, facial dysmorphic features with a broad face, a small mouth and a thin pointed nose, hypotonia, urogenital malformation and proneness to infections. We report a boy with an additional Xq27-qter chromosome segment translocated onto the selleck kinase inhibitor short arm of chromosome 3. The karyotype was 46, XY, der(3)t(X; 3)(q27.3; p26.3) mat. This cryptic unbalanced X-autosome translocation resulted in Xq27-qter functional disomy and a deletion 3p26.3. A detailed analysis of the constitutional chromosomal changes in the patient was performed using array-CGH, FISH and PCR. The aim was to characterize the size and the location of the duplication Xq27-qter (8.18 Mb) and of the deletion 3p26.3 (1.05 Mb), to establish phenotype-genotype correlations and to offer genetic counselling. (c) 2012 Elsevier Masson SAS. All
“Context: Some cases of congenital hypothyroidism (CH) are associated with a gland of normal size.\n\nObjective: To explore Salubrinal in vitro the cause of organification defect in one child with CH and a eutopic thyroid gland, genetic analyses of TPO, DUOX2, and DUOXA2 genes were performed.\n\nPatient: One child with CH, a eutopic thyroid gland, and a partial organification defect was shown after (123)I scintigraphy and perchlorate test.\n\nMethods: In the child with the organification defect, TPO, DUOX2, and DUOXA2 genes were analyzed. The functional activity of the DUOX2 mutants was studied after expression in eukaryotic cells.\n\nResults: No TPO or DUOXA2 gene mutations were identified. Direct sequencing of the DUOX2 gene revealed a compound heterozygous genotype for S911L and C1052Y substitutions. S911L and C1052Y caused a partial defect in H(2)O(2) production after transient expression in HeLa cells.\n\nConclusions: We performed a genetic analysis in one child with CH and a eutopic thyroid gland.
“Objective: To describe the various anesthetic techniques used for surgical closure of PDA in premature infants at the Montreal Children’s Hospital and assess their impact on postoperative outcome.\n\nStudy Design: The charts of all preterms who underwent PDA Selleckchem LCL161 ligation during a 21-month period were reviewed for preoperative status, intraoperative anesthetic management and postoperative outcome. We determined the associations between independent variables and two postoperative outcome variables: unstable postoperative respiratory
course (UPRC) and hypotension.\n\nResult: The mean weight at surgery of the 33 infants was 1.031 +/- 0.29 kg. All infants, but one, received intraoperative opioids. Eight patients presented UPRC. Mean fentanyl doses were 5.3 +/- 2.6 mcg kg(-1) for patients with UPRC vs 22.6 +/- 16.6 mcg kg(-1) for patients without UPRC (P = 0.004). Applying the receiver-operator characteristic curve (ROC), 10.5 mcg kg(-1) of fentanyl Selleck Buparlisib was established as the dose that discriminated and identified patients who experienced UPRC. The postnatal and postmenstrual age of the patient, birthweight, current weight, ventilator settings preoperatively, previous courses of indomethacin, sex and preoperative creatinine, were not correlated with the dose of fentanyl equivalent used. Logistic regression did not show a relationship between any of the
previously mentioned factors and receiving a fentanyl equivalent of > 10.5 mcg kg(-1). The only factor associated with the total fentanyl equivalent dose (as a continuous variable) or receiving < 10.5 mcg kg(-1) (as a dichotomous
variable) was the identity of the anesthetist involved, P < 0.001.\n\nConclusion: We conclude that the use of at least 10.5 mcg kg(-1) of fentanyl equivalent as a component of the anesthetic regimen for surgical closure of a PDA in premature infants, avoids an unstable postoperative respiratory course. Journal of Perinatology (2010) 30, 677-682; doi: 10.1038/jp.2010.24; published online 18 March 2010″
“Purpose Panic Disorder (PD) is a classic example of a disease where symptom remission may be achieved, yet patient quality of life (QOL) remains low, providing further support for the need to measure QOL as an additional outcome P5091 in patient care. The objectives of this review are to examine the substantial QOL impairments in PD and to determine whether modern treatments for PD, which have been proven to achieve symptom remission, have been shown to restore QOL.\n\nMethods We identified studies on QOL in PD from 1980 to 2010 by searching MEDLINE, PsycINFO, and PubMed databases.\n\nResults The literature reveals substantial QOL impairments in PD, often resulting in poor sense of health, frequent utilization of medical services, occupational deficiency, financial dependency, and marital strife.
Studies were included if they had an Selleck SN-38 RCT design, focused on cancer patients or survivors, included physical postures in the yoga program, compared yoga with a non-exercise or waitlist control group, and evaluated physical and/or psychosocial outcomes. Two researchers independently rated the quality of the included RCTs, and high quality was defined as >50% of the total possible score. Effect sizes (Cohen’s d) were calculated for outcomes studied in more than
three studies among patients with breast cancer using means and standard deviations of post-test scores of the intervention and control groups.\n\nResults: Sixteen publications of 13 RCTs met the inclusion criteria, of which one included patients with lymphomas and the others focused on patients with breast cancer. The median quality score was 67% (range: 22-89%). The included studies evaluated 23 physical and 20 psychosocial outcomes. Of the outcomes studied in more
than three studies among patients with breast cancer, we found large reductions in distress, anxiety, and depression (d = -0.69 to -0.75), moderate reductions in fatigue (d = -0.51), moderate increases in general quality of life, emotional function and social function (d = 0.33 to 0.49), and a small increase in functional well-being (d = 0.31). Effects on physical function and sleep were small and not significant.\n\nConclusion: Yoga appeared to be a feasible intervention and beneficial effects on several physical and psychosocial symptoms were reported. selleck chemicals In patients with breast cancer, effect size on functional www.selleckchem.com/products/Imatinib-Mesylate.html well-being was small, and they were moderate to large for psychosocial outcomes.”
“In the past two decades, zebrafish genetic screens have identified a wealth of mutations that have been essential to the understanding
of development and disease biology. More recently, chemical screens in zebrafish have identified small molecules that can modulate specific developmental and behavioural processes. Zebrafish are a unique vertebrate system in which to study chemical genetic systems, identify drug leads, and explore new applications for known drugs. Here, we discuss some of the advantages of using zebrafish in chemical biology, and describe some important and creative examples of small molecule screening, drug discovery and target identification.”
“The most important adverse effect of antithrombotic treatment is the occurrence of bleeding. In case of serious or even life-threatening bleeding in a patient who uses anticoagulant agents or when a patient on anticoagulants needs to undergo an urgent invasive procedure, anticoagulant treatment can be reversed by various specific strategies. Heparin and heparin derivatives can be counteracted by protamine sulphate, whereas the anticoagulant effect of vitamin K antagonists may be neutralized by administration of vitamin K or prothrombin complex concentrates.