ABSTRACT
Prothrombin time (PT) and the activated partial thromboplastin time (aPTT) are useful tools for the diagnosis and monitoring of coagulation disorders in Veterinary Medicine. Our objectives were: to establish reference intervals (RI) for PT and a PTT for the dog using the Start®4 (Stago), to compare the obtained RI with literature; to evaluate the effects of gender and age on the coagulation profile. Plasma samples of 122 healthy dogs (57 males; 65 females) aged between 4 months and 18 years, divided into three age groups (0-2 years old; 3-10 years old; > 10 years old) and grouped in to males and females were analysed. The RI were estimated following the ASVCP guidelines with the Reference Value Advisor software. The RI were: PT 6.7'' to 10.8''; aPTT 9.0'' to 14.8''. PT was significantly higher in females than in males. Dogs aged 10 years or older have significantly higher mean aPTT times than younger dogs. RI comparison showed a considerable percentage of cases outside the reference RI of the literature (PT - 79.3%; aPTT - 77.1%), demonstrating the need of each laboratory to calculate its own RI. The RI established in this study are applicable for the coagulation profile assessment in dogs.
O tempo de protrombina (TP) e o tempo de tromboplastina parcial ativada (TTPa) são ferramentas úteis para o diagnóstico e monitorização das alterações da coagulação em Medicina Veterinária. Os objetivos deste estudo foram: estabelecer intervalos de referência (IR) para TP e TTPa para o cão utilizando o Start®4 (Stago), de modo a comparar os IR obtidos com a literatura; avaliar os efeitos do sexo e da idade no perfil da coagulação. Foram usadas amostras de plasma de 122 cães saudáveis (57 machos; 65 fêmeas) com idades entre quatro meses e 18 anos, divididos em três grupos (0-2 anos; 3-10 anos; > 10 anos) e agrupados em machos e fêmeas. Os IR foram calculados seguindo as diretrizes da ASVCP com o software Reference Value Advisor. Os IR obtidos foram: PT 6,7 '' a 10,8 ''; TTPa 9,0 '' a 14,8 ''. O TP foi significativamente maior nas fêmeas do que nos machos. Os cães com 10 anos ou mais apresentaram tempos médios de TTPa significativamente maiores do que cães mais jovens. A comparação de IR mostrou uma percentagem considerável de casos fora do IR de referência da literatura (TP - 79,3%; TTPa - 77,1%), confirmando a necessidade de cada laboratório calcular seu próprio IR. Os IR estabelecidos neste estudo são aplicáveis na avaliação do perfil hemostático em cães.
Subject(s)
Animals , Dogs , Partial Thromboplastin Time/veterinary , Prothrombin Time/veterinary , Hemostatics/analysis , Reference Values , Sex Factors , Age FactorsABSTRACT
Objective:To explore the predictive value of Red Blood Cell Distribution Width (RDW) in predicting the prognosis of patients with Extracorporeal Membrane Oxygenation (ECMO).Methods:The clinical data of patients undergoing ECMO admitted to Intensive Care Unit of Sichuan Provincial People’s Hospital from January 2015 to January 2020 were retrospectively analyzed. Patients were divided into the survival group and death group according to the prognosis during ICU hospitalization. The patients' basic data , acute physiology and chronic health score system Ⅱ (APACHE Ⅱ), RDW and activated partial thromboplastin time (APTT) at 72 hours after treatment with ECMO were compared between the two groups. Univariate and Logistic regression multivariate analyses were used to analyze the prognostic factors of patients with ECMO, predictive models and death warning scores were established. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficacy of RDW and death warning scores for the prognosis of patients with ECMO.Results:A total of 71 patients with ECMO who met the inclusion criteria were included, including 38 patients in the death group and 33 patients in the survival group. The age, APACHE-Ⅱscore, 72 h RDW and 72 h APTT in the death group were higher than those in the survival group. Respectively, the hospitalization time of ICU in the death group was significantly lower than that in the survival group ( P< 0.05). Logistic regression analysis showed that APACHE-Ⅱscore ( OR=1.117, P=0.047)、72 h RDW( OR=1.102, P=0.029) and 72 h APTT ( OR=1.049, P=0.029) were independent risk factors for death in patients with ECMO. ROC curve analysis showed that the area under ROC curve (AUC) of the APACHE-Ⅱ, score 、72 h RDW and 72 h APTT were 0.691, 0.691 and 0.632( P<0.05), Respectively, the combined AUC was 0.764, the sensitivity was 0.526, and the specificity was 0.909. The death warning score of patients with ECMO was established according to the Predictive model , which is less than 2 points with low risk of death and more than 2 points with high risk of death. The area under the ROC curve of death warning score is 0.8, the sensitivity is 0.607 and the specificity is 0.923. Conclusions:The RDW at 72 hours after treatment with ECMO has a good value in predicting the prognosis of patients with ECMO. Besides, a greater predictive value for the prognosis of patients with ECMO by combining 72 hours RDW, 72 hours APTT with APACHE-Ⅱscore than that of any separate indicator.
ABSTRACT
Aim:Ibuprofen is analgesic, antipyretic and anti-inflammatory drug, which is widely used as a cheap over-the counter drug(OTC); however, this drug accompanies anti coagulation/anti platelets effects which sometimes might illicit adverse effects. In this study, we investigated effect of ibuprofen on prothrombin time (PT), activated partial thromboplastin time (aPTT) and platelet count using wistar albino rats.Methods:A total of 21 rats grouped into 3(control, acute and chronic exposure groups, with all consisting of 7rats each) was used. The acute and chronic exposure group were given 0.7mg of ibuprofen orally for 1 and 21 days, respectively. Blood sample was collected via cardiac puncture thenanalyzed.Results:PT was significantly higher in both group 2 and 3 (acute and chronic exposure, respectively)than that of the control. Acute exposure group showed the highest PT rise.A PTT was not significantly different between group 2 and 3 versus the control group. Platelet count was significantly lower in both group 2 and 3than that in the control group (p<0.05). Group 3 (chronic exposure) showed the lowest platelet count.Conclusion:Oral administration of ibuprofen affected coagulation parameters and a longer exposure reduce platelets count. A strictly prescription for this drug may be needed to prevent its indiscriminate use
ABSTRACT
Aim To explore the feasibility of APTT bioactivity detection for Xuesaitong injection. Methods The APTT values of rabbit plasma of samples/reference were detected by automatic coagulometer, and the data were analyzed by bioassay statistics. Results The results of repeated test of different rabbit plasma, multiple enterprises and various concentrations of Xuesaitong injection were stable. The APTT values of standard ginsenoside Rb1, ginsenoside Rg1, notoginsenoside R1 and Panax notoginseng saponins were compared with that of Xuesaitong injection, and the APTT values of the former three were not correlated with Xuesaitong injection; while the Panax notoginseng saponins were significantly correlated with Xuesaitong injection. The panax notoginseng saponins were used as the reference material, and the results were consistent with those of the physical and chemical analysis. Conclusions The active ingredients in Xuesaitong injection do not represent the effective ingredients, and its medicinal effect is the result of the combined action of various ingredients. Therefore, it is not suitable to simply look for some monomer as the control. This paper suggests using panax notoginseng saponins as the control substance to explore the biological activity study of injections for promoting blood circulation and removing blood stasis.
ABSTRACT
Abstract Introduction Type 2 diabetes mellitus, characterized by insulin resistance, corresponds to approximately 90% of cases of diabetes worldwide. Hyperglycemia in diabetes contributes to hyperfibrinogenemia and activates the coagulation cascade thereby producing atherothrombotic events. Objectives This study was designed to evaluate the coagulation profile (activated partial thromboplastin time, prothrombin time and fibrinogen) in Type 2 diabetes and to analyze correlations between body mass index, fasting blood glucose, glycated hemoglobin and duration of diabetes with coagulation parameters. Methods This study included 60 type 2 diabetics and 30 controls. Diabetic patients were grouped in two sets based on the presence or absence of microvascular complications. The demographic profile and clinical details were recorded. Fasting blood glucose, glycated hemoglobin, coagulation parameters such as prothrombin time, activated partial thromboplastin time and fibrinogen along with other biochemical parameters were investigated. Results There were statistically significant differences in the coagulation parameters between the two groups of diabetics (with and without complications). The present study also found significant correlations between age and the duration of diabetes with and without complications and coagulation parameters such as the activated partial thromboplastin time, which was found to be significantly lower, and fibrinogen, which was found to be significantly higher in subjects with complications compared to subjects without complications. Conclusion Clinical tests for prothrombin time, activated partial thromboplastin time and fibrinogen are relatively inexpensive and readily available. The present study shows that shortened prothrombin time, activated partial thromboplastin time and increased fibrinogen levels might be useful hemostatic markers in diabetic patients, especially in those at high-risk for thrombotic complications.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Partial Thromboplastin Time , Prothrombin Time , Diabetes Mellitus, Type 2 , Glycemic ControlABSTRACT
Background: Dengue is a systemic viral infection transmitted by mosquitoes such as Aedes aegypti or Aedes albopictus. Dengue Fever (DF) is characterized by fever, headache, muscle or joint pain, and rash. The spectrum of dengue virus infection spreads from an undifferentiated fever and dengue fever (DF) to dengue haemorrhagic fever (DHF) with shock. Factors responsible for bleeding manifestations in dengue are vasculopathy, thrombocytopenia, coagulopathy, and disseminated intravascular coagulation (DIC). Coagulopathy results in derangement of activated partial thromboplastin time (APTT) which is an indicator of impending bleeding risk.Methods: A prospective study was conducted from June to December in 2017 in R L Jalappa Hospital. Patients aged above 18 years with febrile thrombocytopenia who are positive for dengue virus serology (NS1Ag and/ or IgM) were included in the study. Serial daily monitoring of platelet count and analysis of APTT levels were done. APTT was considered abnormal if it was more than 33.8s. Patients were followed up for evidence of leaking and bleeding manifestations.Results: Out of 170 patients 28.1% patients had bleeding manifestations. Bleeding signs were seen on clinical examination in 52.37% of patients. capillary leak was found in the form of Pleural effusion in 35.3%, Ascites in 41.2% and Periorbital edema in 31.2% of patients. Elevated APTT levels were seen in 110(64.7%) patients. Among patients with abnormal APTT platelet transfusion was done in 78.9% of patients, and among those with normal APTT levels platelet transfusion was done in 21.1% of patients.Conclusions: Our study showed significant correlation between bleeding manifestations and prolonged APTT levels as well as thrombocytopenia with abnormal APTT levels. Study concluded that 21.1% of platelet transfusions could have been prevented considering prolonged APTT as a predictor of bleeding manifestation, thus saving the resources and reactions due to platelet concentrate transfusion.
ABSTRACT
Abstract@#Introduction: Arterial and venous thromboses contribute to significant morbidity and mortality rate, thus an antithrombotic agent is needed for prevention and treatment of thrombosis. Ajwa dates (Phoenix dactylifera L.) reportedly contain a high level of salicylic acid which is a compound responsible for anticoagulation via antagonism of vitamin K. The present study was designed to assess coagulation activities in human plasma treated with Ajwa date extracts in vitro. Methods: Platelet-poor plasma samples from 27 donors were treated with ethanol crude date extract (ET) or aqueous crude date extract (AQ) of Ajwa dates at different concentrations to generate the following seven test groups from each donor: control (normal saline), ET-I (0.1 g/mL), ET-II (0.5 g/mL), ET-III (1.0 g/mL), AQ-I (0.1 g/ mL), AQ-II (0.5 g/mL) and AQ-III (1.0 g/mL). In vitro coagulation activities of Ajwa dates were assessed based on prothrombin time (PT, an assessment of extrinsic coagulation pathway), activated partial thromboplastin time (APTT, an assessment of the intrinsic coagulation pathway), and thrombin time (TT, an evaluation of level and function of fibrinogen). Results: A very significant prolongation of PT, APTT and TT were observed for the ET-II and ET-III groups and very significant prolongation of PT and TT was observed for the AQ-II and AQ-III groups. Significant prolongation of TT was observed in the AQ-I group. Conclusion: In conclusion, Ajwa date extracts had an anticoagulation effect on human plasma.
ABSTRACT
Objective To activate partial thromboplastin time (APTT) indicating the coagulation state in intrinsic coagulation system and the efficacy of anticoagulant drugs, and develop a bioassay method to quantify anticoagulating bioactivity in Chuanxiong Rhizome and related Chinese patent medicines for quality assessment. Methods Chuanxiong Rhizome powder was extracted in ethanol and water, respectively. The mixed extract was used as sample to quantify the level of extended APTT in vitro. The blood was taken from the heart of rabbit. The agglomerating time was determined after adding APTT reagent in plasma. The prolongation rate of APTT was chosen as biomarker for anticoagulating bioactivity. Sodium ferulate was chosen as reference. The amount of anticoagulating bioactivity was quantified in Chuanxiong Rhizome extract by the Amount reaction of parallel line analysis (2.2) method. Moreover, the amounts of anticoagulating bioactivity were quantified in the nine Chuanxiong Rhizome samples including Chuanxiong Rhizome raw materials, decoction pieces, and related Chinese patent medicines. Results Both sodium ferulate and Chuanxiong Rhizome extract showed significant anticoagulating bioactivity (P < 0.01). The reliability test for quantifying the level of anticoagulating bioactivity in solidum ferulate and Chuanxiong Rhizome extract was passed through, and the measured value was valid. The correlation coefficient was 0.995 5 (n = 5) between the concentration of solidum ferulate in the range of 1 — 5 mg/mL and their rates of anticoagulating bioactivity. The RSD for the amounts of anticoagulating bioactivity was 9.34% (n = 6) by six replicated tests with the confidence limit rate of 15.98% (n = 6). The amounts of anticoagulating bioactivity were significant difference among various types of Chuanxiong Rhizome samples, i.e. 5.431 — 7.620 U/g for five Chuanxiong Rhizome raw materials, 5.910 and 3.017 U/g for Chuanxiong decotion pieces and processed slice with yellow wine, 14.516 and 29.035 U/g for Tongmai Granules and Xuefu Zhuyu Pills. Conclusion The developed method can accurately quantify the level of anticoagulating bioactivity in Chuanxiong Rhizome raw materials, decoction pieces and related Chinese patent medicines, and assess their quality.
ABSTRACT
Abstract: We report a case of acquired hemophilia A diagnosed after hospitalization in a palliative care unit. Case: The patient was an 86-year-old man diagnosed with gastric carcinoma one-year prior, who declined treatment but whose progress was being monitored. He was admitted to our hospital due to multiple, systemic, and subcutaneous bleeding and exacerbation of anemia. Blood testing revealed prolonged activated partial thromboplastin time (APTT), but the cause was unknown. Subcutaneous bleeding persisted after hospitalization, accompanied by pain. After admission to a palliative care unit, blood testing revealed only prolonged APTT; hence, a coagulation study was performed, resulting in a diagnosis of acquired hemophilia A. Immunosuppressive therapy was considered but was not performed as the patient’s progress was complicated by aspiration pneumonia for which antibiotics were ineffective, and the patient’s prognosis was determined to be short. The patient died on the 20th day after admission to the palliative care unit. Conclusion: Acquired hemophilia A is a rare hemorrhagic condition, but it is important to suspect it in cases involving prolonged APTT and spontaneous bleeding with no medical history or family history.
ABSTRACT
In order to investigate the effect of various production processes on the quality of Safflower Injection, the biological activities of the intermediates were evaluated by measuring activated partial thromboplastin time (APTT) and adenosine diphosphate (ADP) induced platelet aggregation in vitro. Intermediates were produced by key processes, such as extraction, concentration, twice alcohol precipitation, water sedimentation and two sterilizations during the production of Safflower Injection. The content of main chemical components in intermediates was determined by HPLC. The results showed that with the advance of the preparation process of Safflower Injection, the inhibition of ADP-induced platelet aggregation rate of each intermediate decreased gradually, and the trend of extending APTT activity decreased first and then increased. Meanwhile, the content of hydroxy safflor yellow A (HSYA) was gradually lowered, the content of p-hydroxy-cinnamic acid was increased, and new chemical component p-hydroxybenzaldehyde was produced. In conclusion, sterilization played a key role in the biological activity and HSYA content of Safflower injection.
Subject(s)
Carthamus tinctorius , Chalcone , Chromatography, High Pressure Liquid , Partial Thromboplastin Time , Platelet AggregationABSTRACT
Objective To explore the changes of coagulation factors in Xinjiang Uygur and Han patients with diabetic mellitus in order to provide reference for the prevention and treatment of diabetic mellitus patients.Methods 2 100 patients with diabetic mel-litus were taken as the patient group which were diagnosed in our hospital between February 2014 and April 2015,another 446 healthy people were collected as the control group.The difference of coagulation between diabetic mellitus group and control group was compared.Coagulation between Uygur and Han was compared for 2 100 diabetic mellitus patients.Results The APTT of dia-betic mellitus group were significantly less than that in control group(P 0.05).The APTT of Uygur group were significantly less than Han group(P 0.05).Conclusion Fac-tors were difference of diabetic mellitus patients and healthy people,coagulation factors in diabetic mellitus patients of Xinjang Uygur and Han.
ABSTRACT
Objective To investigate the change of coagulation indexes in the patients with bee sting injury .Methods A total of 294 cases of bee sting injury were selected as the study subjects and divided into the mild bee sting injury group (A ,1 -2 sites) , moderate bee sting injury group(B ,3-10sites) ,severe bee sting injury group(C ,11-20sites) and extremely severe bee sting injury group(D ,≥21sites) according to the number of sting site .Meanwhile 40 healthy people were selected as the control group .The changes of prothrombin time(PT),internation alnormalized ratio(INR),activated partial thromboplastin time(APTT)and fibrinogen(FIB) were compared among groups .Results PT and APTT in the severe bee sting injury group and extremely severe bee sting injury group were significantly prolonged within 4-9 h after bee sting injury compared with the control group (P＜0 .05) .APTT , PT and INR had obviously dose effect positive correlation with bee sting sites (r=0 .583 ,0 .340 ,0 .327 ,P＜0 .01) .Conclusion APTT is closely correlated with bee sting sites and seeing doctor time ,which can serve as the effective monitoring indexes in the treatment process of bee sting injury .
ABSTRACT
Objective To investigate the changes of blood biochemical indexes in patients with severe burn ,so as to improve the reference of clinical treatment plan .Methods Totally 152 patients with severe burn treated in the hospital from February 2012 to October 2016 were selected as the observation group ,the blood coagulation indexes of APTA ,PT ,TT ,INR ,FBg ,PLT ,and ALB , AST ,ALT ,TP ,NO ,ESR ,blood CO2 ,UA ,HDL-C ,CHOL ,RBC ,HGB and HCT blood index were measured ;and 92 cases of mild and moderate burn patients were selected as control group ,the similar indexes of two groups were compared .Results The heart rate ,respiratory rate ,diastolic blood pressure and systolic blood pressure in the severe burn group were significantly higher than those in the control group(P< 0 .05) .The levels of APTT ,PT ,TT ,INR ,FBg and PLT in severe burn group were significantly higher than those in control group(P<0 .05) .The levels of AST ,ALT and NO in severe burn group were significantly higher than those in the control group (P<0 .05);the levels of ALB ,TP ,CO2 ,UA ,HDL-C ,CHOL ,HGB ,RBC and HCT were significantly lower than those of the control group(P<0 .05) .Conclusion Through the detection of severe burn patients with some blood inde-xes ,according to changes in coagulation indexes and biochemical indicators to determine the characteristics of the patient′s injury ,assist doctors in the diagnosis and treatment of patients ,could be timely rehydration ,nutritional support ,improve coagulation status ,improve pa-tient immunity .
ABSTRACT
Objective To investigate the changes of blood biochemical indexes in patients with severe burn ,so as to improve the reference of clinical treatment plan .Methods Totally 152 patients with severe burn treated in the hospital from February 2012 to October 2016 were selected as the observation group ,the blood coagulation indexes of APTA ,PT ,TT ,INR ,FBg ,PLT ,and ALB , AST ,ALT ,TP ,NO ,ESR ,blood CO2 ,UA ,HDL-C ,CHOL ,RBC ,HGB and HCT blood index were measured ;and 92 cases of mild and moderate burn patients were selected as control group ,the similar indexes of two groups were compared .Results The heart rate ,respiratory rate ,diastolic blood pressure and systolic blood pressure in the severe burn group were significantly higher than those in the control group(P< 0 .05) .The levels of APTT ,PT ,TT ,INR ,FBg and PLT in severe burn group were significantly higher than those in control group(P<0 .05) .The levels of AST ,ALT and NO in severe burn group were significantly higher than those in the control group (P<0 .05);the levels of ALB ,TP ,CO2 ,UA ,HDL-C ,CHOL ,HGB ,RBC and HCT were significantly lower than those of the control group(P<0 .05) .Conclusion Through the detection of severe burn patients with some blood inde-xes ,according to changes in coagulation indexes and biochemical indicators to determine the characteristics of the patient′s injury ,assist doctors in the diagnosis and treatment of patients ,could be timely rehydration ,nutritional support ,improve coagulation status ,improve pa-tient immunity .
ABSTRACT
Los objetivos del trabajo fueron verificar la calidad analítica del ensayo tiempo de trombina diluido (DTI) para medición de la concentración plasmática (cc) de dabigatran comparando dos coagulómetros de detección foto-óptica, comparar los resultados con el tiempo de Ecarin (ECT) y correlacionar las cc con las pruebas básicas de coagulación Tiempo de protrombina (TP), APTT y Tiempo de trombina (TT), y tiempo de veneno de víbora de Russell con fosfolípidos concentrados (DRVVTC). Se tomaron 43 muestras de plasma en el valle (10-14 h de la última toma) de 40 pacientes que recibían dabigatran. DTI y ECT presentaron (%) repetitividad <5,4% y <7,5%, CV interensayo <6% y <9%, respectivamente, en el protocolo EP15A2, aceptables para un Error Total permitido (TEa) <15%. Las cc medidas en pacientes fueron: mediana 83 (4-945) ng/mL. La comparación de equipos ACL TOP 300 y 500 dio resultados equivalentes por procedimiento alternativo de comparación de métodos. La comparación ECT vs. DTI fue satisfactoria por regresión de Deming (pendiente 1,143, ordenada al origen -19,33). Las correlaciones de cc vs. APTT, TP y DRVVTC fueron moderadas y no lineales tendiendo a plateau a cc>350 ng/mL, r2 0,59, 0,66 y 0,59, respectivamente. El TT fue extremadamente sensible: >120 s a cc 50 ng/mL. DTI presentó un buen desempeño analítico y permitió cuantificar dabigatran plasmático a cc bajas y altas en ambos equipos utilizados. ECT presentó resultados comparables a DTI. Se verifica una correlación moderada entre cc de dabigatran y las pruebas clásicas y DRVVTC, pudiendo ser estimadores de cc a partir de los 50 ng/mL.
The aims of the study were to verify the analytical performance of Dilute Thrombin Time (DTI) test to measure plasma dabigatran concentration (cc) in two photo-optical coagulometers, compare Ecarin clotting Time (ECT) and DTI results, and correlate cc with classical coagulation tests: prothrombin time (PT), APTT, thrombin time (TT) and diluted Russell Viper Venom Time tests with high phospholipid concentration (DRVVTC). Forty three plasma samples from 40 patients taking dabigatran were drown at through (10-14 hs.since last dose). DTI and ECT showed repetitivity (%) <5.4% and <7.5%, interassay CV <6% and <9%, respectively, following EP15A2 protocol, acceptable considering a Allowed Total Error (TEa)<15%. Patients` cc: median 83 (4-945) ng/mL. The comparison between ACL TOP 300 and 500 coagulometers showed equivalent results by using the alternative method comparison test. ECT vs. DTI: acceptable by Deming`s regression (slope 1.143, Y insert -19.33). cc vs. APTT, TP and DRVVTC: nonlinear and moderate correlations with plateau reached at cc >350 ng/mL, r2 0.59, 0.66 y 0.59, respectively. TT is extremely prolonged at cc >50 ng/mL. In conclusion: DTI showed a good analytical performance in both coagulometers. ECT showed comparable results to DTI. We verified that dabigatran cc presented moderate correlations with PT, APTT and DRVVTC, and that these tests could only qualitative estimate cc >50 ng/mL.
Os objetivos do trabalho foram verificar a qualidade analítica do ensaio tempo de trombina diluído (DTI) para medição da concentração plasmática (cc) de dabigatrana, comparando dois coagulômetros de detecção foto-óptica, comparar os resultados com o tempo de Ecarina (ECT) e correlacionar as cc com os testes básicos de coagulação Tempo de protrombina (TP), APTT e Tempo de trombina (TT), e tempo de veneno de víbora de Russell com fosfolipídios concentrados (DRVVTC). Foram tomadas 43 amostras de plasma no vale (10-14 h. da última toma) de 40 pacientes que recebiam dabigatrana. DTI e ECT apresentaram (%) repetitividade <5,4% e <7,5%, CV interensaio <6% e <9%, respectivamente, no protocolo EP15A2, aceitáveis para um Erro Total permitido (TEa) <15%. Cc medidas em pacientes: mediana 83 (4-945) ng/mL. Comparação de equipamentos ACL TOP 300 e 500: resultados equivalentes por procedimento alternativo de comparação de métodos. Comparação ECT vs. DTI: satisfatória por regressão de Deming (pendente 1,143, ordenada à origem -19,33). Correlações cc vs. APTT, TP e DRVVTC: moderadas e não lineares tendendo a plateau a cc>350 ng/mL, r2 0,59; 0,66 e 0,59, respectivamente. O TT é extremamente sensível: >120 s a cc 50 ng/mL. DTI apresentou um bom desempenho analítico e permitiu quantificar dabigatrana plasmática a cc baixas e altas em ambos os equipamentos utilizados. ECT apresentou resultados comparáveis com DTI. Verifica-se uma correlação moderada entre cc de dabigatrana e os testes clássicos e DRVVTC, podendo ser estimadores de cc a partir dos 50 ng/mL.
Subject(s)
Humans , Male , Female , Prothrombin Time , Thrombin , Dabigatran , Phospholipids , Thrombin TimeABSTRACT
BACKGROUND: Unfractionated heparin (UFH) has unstable pharmacokinetics and requires close monitoring. The activated partial thromboplastin time (aPTT) test has been used to monitor UFH therapy for decades in Korea, but its results can be affected by numerous variables. We established an aPTT heparin therapeutic range (HTR) corresponding to therapeutic anti-Xa levels for continuous intravenous UFH administration, and used appropriate monitoring to determine if an adequate dose of UFH was applied. METHODS: A total of 134 ex vivo samples were obtained from 71 patients with a variety of thromboembolisms. All patients received intravenous UFH therapy and were enrolled from June to September 2015 at Gyeongsang National University Hospital. All laboratory protocols were in accordance with the Clinical and Laboratory Standards Institute guidelines and the College of American Pathologist requirements for aPTT HTR. RESULTS: An aPTT range of 87.1 sec to 128.7 sec corresponded to anti-Xa levels of 0.3 IU/mL to 0.7 IU/mL for HTR under our laboratory conditions. Based on their anti-Xa levels, blood specimen distribution were as follows: less than 0.3 IU/mL, 65.7%; 0.3–0.7 IU/mL (therapeutic range), 33.6%; and more than 0.7 IU/mL, 0.7%. No evidence of recurring thromboembolism was observed. CONCLUSION: Using the conventional aPTT target range may lead to inappropriate dosing of UFH. Transitioning from the aPTT test to the anti-Xa assay is required to avoid the laborious validation of the aPTT HTR test, even though the anti-Xa assay is more expensive.
Subject(s)
Humans , Heparin , Korea , Partial Thromboplastin Time , Pharmacokinetics , ThromboembolismABSTRACT
The global demand for natural products from seaweeds has increased worldwide; however, no description of the use of isoamly alcohol (IAA) for obtaining of sulfated polysaccharides (SPs) has been reported. We investigated the efficiency of two precipitation methods (M) in obtaining SPs from the red seaweed Gracilaria cornea. SPs enzymatically isolated were concentrated with cetylpyridinium chloride (M I) or IAA (M II) and extracts were examined with regard to their yield, structural features and in vitro effects on the activated partial thromboplastin time (APTT) using normal human plasma and standard heparin (193 IU mg-1). Yield difference reached 12.99%. Quantitative determination of sulfate was similar between the two methods (Ì´26%), but extracts revealed different pattern on charge density by agarose gel electrophoresis. Whereas both extracts revealed as agarocolloids, alternative M II was also efficient for lipids, proteins and nucleic acids according to the infrared analysis. Extracts had virtually no effect on APPT (1.95 and 2 IU mg-1 for M I and M II, respectively). The results revealed IAA as an alternative solvent for obtaining SPs from the red seaweed G. cornea, depending on the industry' usage criterion.
A demanda global de produtos naturais de algas marinhas tem aumentado mundialmente. Entretanto, a obtenção de polissacarídeos sulfatados (PSs) com álcool isoamílico (AIA) não é relatada. Investigou-se a eficiência de dois métodos (M) de precipitação de PSs da alga marinha vermelha Gracilaria cornea. Os PSs isolados enzimaticamente foram concentrados com cloreto cetilpiridimínio (M I) ou AIA (M II). Os extratos foram examinados, segundo seu rendimento, características estruturais e efeitos in vitro sobre o tempo de tromboplastina parcial ativada (TTPA) usando plasma humano normal e heparina padrão (193 UI mg-1). A diferença nos rendimentos foi 12,99% e semelhante determinação quantitativa de sulfato foi obtida entre os métodos (Ì´26%). A eletroforese em gel de agarose revelou diferenças em termos de densidade de cargas entre os extratos. Enquanto ambos os extratos revelaram agarocoloides, o método M II também se mostrou alternativo para lipídios, proteínas e ácidos nucleicos de acordo com a análise de infravermelho. Os extratos praticamente não modificaram o TTPA (1,95 e 2 UI mg-1 para M I e M II, respectivamente). Os resultados revelaram AIA como um solvente alternativo para obtenção de PSs da alga marinha vermelha G. cornea, dependendo do critério de utilização na indústria.
Subject(s)
Rhodophyta , SeaweedABSTRACT
OBJECTIVE: To assay the anticoagulant activity of leeches by using biological standardization method with the aim to explore the quality control method which can reflect the biological activity. METHODS: Heparin was used as the reference substance, and APTT value was used as the index of anticoagulant activity evaluation. Four species of leeches were determined, including Hirudo nipponia Whitman, Poecilobdella manillensis Lesson, Poecilobdella javanica Wahlberg, and Whitmania pigra Whitman. The determination results were calculated with standard curve and bioassay statistics. RESULTS: The concentration-response curves of APTT of the four species of leeches were similar to that of heparin, and their variation ranges were parallel. CONCLUSION: APTT values can reflect the comprehensive anticoagulant activity of different species of leeches, which may have more clinical significance. Biological standardization is a good supplement to the current quality control methods, also a proper technology for the quality control of TCM.
ABSTRACT
This article was aimed to study macroporous resin adsorption kinetics for effective extraction of water ex-tracting with alcohol precipitating in cicada slough. PT, APTT and the coagulation-fibrinolysis dynamic figure were taken as main indexes, which were combined with static and dynamic tests, to select the best macroporous resin to separate and purify the extraction. Adsorption kinetics curve was drawn to fit the adsorption kinetics model. The re-sults showed that NKA-9 macroporous resin was more effective in separating and purifying effective extraction than others. The adsorption dynamic behavior was well described by the pseudo-second-order kinetics equation. It was concluded that the adsorption rate was mainly controlled by the intraparticle diffusion.
ABSTRACT
Studies on macromolecules isolated from marine algae suggested sulfated polysaccharides (SPs) as possible molecular markers for species. We evaluated isolated and fractionated SPs from the green marine algae Caulerpa cupressoides, C. prolifera and C. racemosa collected at Pacheco Beach, as possible taxonomic molecular indicators. Total SPs were extracted with papain in 100 mM sodium acetate buffer (pH 5.0) containing cysteine and EDTA (both 5 mM), followed by ion-exchange chromatography on DEAE-cellulose using a NaCl gradient. The obtained fractions were analyzed by 0.5% agarose gel electrophoresis. Anticoagulant assays employing normal human plasma and standard heparin (193 IU mg-1) by the activated partial thromboplastin time (APTT) test were also performed as comparison parameters. Low yields, and similar chromatographic profiles were found among species' SPs, but electrophoresis revealed distinct SPs resolution patterns. The changes in APTT of SP fractions were dependent on charge density as showed by electrophoresis profiles. Activities were 17.37 (C. cupressoides), 22.17 (C. racemosa) and 25.64 (C. prolifera) IU mg-1, respectively, similar to a previous study using the first and second species. The results suggest that comparative studies of SPs isolated from seaweeds may be an important tool for the identification of Caulerpaceae.
A utilização de macromoléculas isoladas de organismos marinhos sugere correlacionar características em estudos taxonômicos e a investigação comparativa de polissacarídeos sulfatados (PSs) de algas despertam seu interesse como marcadores moleculares. Objetivou-se avaliar PSs isolados e fracionados das algas marinhas verdes Caulerpa cupressoides, C. prolifera e C. racemosa, coletadas na Praia do Pacheco, Estado do Ceará, como possíveis indicadores moleculares taxonômicos. Os PSs totais foram extraídos com papaína em tampão acetato de sódio 100 mM (pH 5,0) contendo cisteína e EDTA (ambos 5 mM), seguido por cromatografia de troca iônica em coluna de DEAE-celulose utilizando um gradiente de NaCl. As frações obtidas foram analisadas por eletroforese em gel de agarose a 0,5%. Ensaios anticoagulantes, utilizando o teste do tempo de tromboplastina parcial ativada (TTPA) com plasma humano normal e heparina padrão (193 UI mg-1), também foram realizados como parâmetros de comparação. Verificaram-se baixos rendimentos e semelhantes perfis cromatográficos entre os PSs das espécies, porém revelando, por eletroforese, diferenças moleculares marcantes. As alterações no TTPA das frações de PS foram dependentes da densidade de cargas negativas mostradas nos perfis eletroforéticos, cujas atividades foram 17,37 (C. cupressoides), 22,17 (C. racemosa) e 25,64 (C. prolifera) UI mg-1, respectivamente, e tal propriedade justificou um estudo já realizado utilizando a primeira e segunda espécies. Os resultados sugerem que estudos comparativos de PSs isolados de algas marinhas possam vir a ser uma ferramenta importante na identificação de Caulerpaceae.