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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(2): 583-587, 2020 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-32319400

RESUMO

OBJECTIVE: To investigate the clinical characteristics and risk factors of low fibrinogenemia (LF) induced by hemocoagulase. METHODS: Clinical data of 57 patients with hypofibrinogenemia (LF group) treated with hemocoagulase during Jan.2015 to Oct. 2018 in our hospittal were analyzed retrospectively. The control group consisted of 60 patients who did not develop hypofibrinogenemia treated with hemocoagulase. The clinical characteristics were compared between these two groups, the univariate analysis and multivariate analysis were also performed. RESULTS: In LF group, the fibrinogenemia occurred on 5.4(σ=1.067) days after use of hemocoagulase,with the main manifestations as bleeding from the operation or wound site, the decrease of fibrinogen (0.694 g/L,σ=0.211), the increase of D-dimer (4.468µg/mL,σ=1.442) and the recovery of Fib on the day 3.93 (σ=0.563) after drug withdrawal. There were significant differences in age, sex, primary disease, origin of snake venom, course of treatment, complication of hepatic and renal insufficiency and route of administration between the 2 groups (P<0.05). Multivariate logistic regression analysis showed that age(P=0.007,OR=11.248), course of treatment (P<0.001,OR=72.104) and route of administration (P=0.049,OR=13.389) were risk factors for hypofibrinogenemia. CONCLUSION: The use of hemocoagulase should be vigilant against the occurrence of hypofibrinogenemia. Old age, long course of treatment and the intravenous administration may increase the risk of hypofibrinogenemia.


Assuntos
Afibrinogenemia , Hemostáticos , Batroxobina , Humanos , Estudos Retrospectivos , Fatores de Risco
2.
Medicine (Baltimore) ; 98(52): e18534, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876750

RESUMO

BACKGROUND: Hemocoagulase is isolated and purified from snake venoms. Hemocoagulase agents have been widely used in the prevention and treatment of surgical bleeding. A systematic review was performed to evaluate the effects of hemocoagulase on postoperative bleeding and transfusion in patients who underwent cardiac surgery. METHODS: Electronic databases were searched to identify all clinical trials comparing hemocoagulase with placebo/blank on postoperative bleeding and transfusion in patients undergoing cardiac surgery. Two authors independently extracted perioperative data and outcome data. For continuous variables, treatment effects were calculated as weighted mean difference and 95% confidential interval (CI). For dichotomous data, treatment effects were calculated as odds ratio and 95% CI. Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity. Sensitivity analyses were done by examining the influence of statistical model and individual trial on estimated treatment effects. Publication bias was explored through visual inspection of funnel plots of the outcomes. Statistical significance was defined as P < .05. RESULTS: Our search yielded 12 studies including 900 patients, and 510 patients were allocated into hemocoagulase group and 390 into control group. Meta-analysis suggested that, hemocoagulase-treated patients had less bleeding volume, reduced red blood cells and fresh frozen plasma transfusion, and higher hemoglobin level than those of controlled patients postoperatively. Meta-analysis also showed that, hemocoagulase did not influence intraoperative heparin or protamine dosages and postoperative platelet counts. Meta-analysis demonstrated that, hemocoagulase-treated patients had significantly shorter postoperative prothrombin time, activated partial thromboplastin time, and thrombin time, higher fibrinogen level and similar D-dimer level when compared to control patients. CONCLUSION: This meta-analysis has found some evidence showing that hemocoagulase reduces postoperative bleeding, and blood transfusion requirement in patients undergoing cardiac surgery. However, these findings should be interpreted rigorously. Further well-conducted trials are required to assess the blood-saving effects and mechanisms of Hemocoagulase.


Assuntos
Batroxobina/uso terapêutico , Transfusão de Sangue/estatística & dados numéricos , Procedimentos Cirúrgicos Cardíacos/métodos , Hemostáticos/uso terapêutico , Hemorragia Pós-Operatória/prevenção & controle , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Humanos
3.
PLoS One ; 14(8): e0220898, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31419236

RESUMO

Batroxobin, isolated from Bothrops moojeni, is a defibrinogenating agent used as a thrombin-like serine protease against fibrinogen for improving microcirculation. Here, we investigated whether, and if so, how batroxobin restores ischemic tissue injury in terms of anti-inflammatory effects. In an in vitro flow cytometry assay for human neutrophil extracellular traps (NETs), batroxobin (DF-521; Defibrase) inhibited human NETs induced by tumor necrosis factor-α (TNF-α) in the presence of human fibrinogen. Next, the effect of batroxobin was investigated by immunohistochemistry of the anterior tibial muscle (ATM) in an ischemic hindlimb model using C57BL/6J mice intraperitoneally injected with DF-521 versus the saline control. NETs and fibrinogen deposition in the ischemic ATM decreased in DF-521-treated mice on day 2 after ischemia. Meanwhile, reverse transcription-quantitative PCR assay of the ischemic ATM unveiled continuous downregulation in the expression of the genes; Tnf-α and nitric oxide synthase2 (Nos2) with hypoxia-inducible factor-1α (Hif-1α) and vascular endothelial growth factor-a (Vegf-a) from day 3 to day 7, but the upregulation of arginase-1 (Arg-1) and placental growth factor (Plgf) with myogenin (Myog) on day 7. Daily intraperitoneal DF-521 injection for the initial 7 days into mice with ischemic hindlimbs promoted angiogenesis and arteriogenesis on day 14. Moreover, DF-521 injection accelerated myofiber maturation after day 14. Laser doppler imaging analysis revealed that blood perfusion in DF-521-injected mice significantly improved on day 14 versus the saline control. Thus, DF-521 improves microcirculation by protecting NETs with tissue defibrinogenation, thereby protecting against severe ischemic tissue injury and accelerating vascular and skeletal muscular regeneration. To our knowledge, batroxobin might be the first clinically applicable NET inhibitor against ischemic diseases.


Assuntos
Batroxobina/uso terapêutico , Armadilhas Extracelulares/efeitos dos fármacos , Fibrinolíticos/uso terapêutico , Isquemia/tratamento farmacológico , Adulto , Animais , Anti-Inflamatórios/uso terapêutico , Células Cultivadas , Modelos Animais de Doenças , Armadilhas Extracelulares/imunologia , Membro Posterior/irrigação sanguínea , Humanos , Inflamação/tratamento farmacológico , Inflamação/imunologia , Isquemia/imunologia , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Cicatrização/efeitos dos fármacos , Adulto Jovem
4.
Curr Drug Saf ; 14(3): 230-232, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31124425

RESUMO

BACKGROUND: Hemocoagulase agkistrodon has been widely used for visceral bleeding, however, its adverse reaction has not been fully recognized. CASE REPORT: A 65-year-old female with upper gastrointestinal hemorrhage occurred severe coagulation disorder during her hospitalization. Transfusion of blood products can not improve coagulation function. Coagulation parameters returned to normal two days after discontinuation of hemocoagulase agkistrodon. CONCLUSION: So intravenous administration of hemocoagulase should be cautiously used for the treatment of gastrointestinal bleeding.


Assuntos
Batroxobina/uso terapêutico , Fatores de Coagulação Sanguínea/uso terapêutico , Hemorragia Gastrointestinal/tratamento farmacológico , Idoso , Hemorragia Gastrointestinal/induzido quimicamente , Humanos
5.
Int Immunopharmacol ; 72: 235-242, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31003000

RESUMO

OBJECTIVE: Batroxobin is a medicinal preparation extracted from the venom of the Fer-de-Lance snake, and is used to lower blood viscosity, promote blood fibrinogen decomposition, and inhibit thrombosis. This research is to investigate whether batroxobin can improve the survival of random skin flaps in a rat model. MATERIALS AND METHODS: Dorsal McFarlane flaps were harvested from 36 rats divided into two groups. Experimental group: Batroxobin was administered via the tail vein once daily. CONTROL GROUP: The same amount of normal saline was injected instead. On day 2, superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured. On day 7, tissue slices were stained with haematoxylin and eosin. Expression of vascular endothelial growth factor (VEGF) was immunohistochemically evaluated. Microcirculatory flow was measured by laser Doppler flowmetry. Flap angiography, using the lead oxide-gelatin injection technique, was performed with the aid of a soft X-ray machine. RESULTS: The batroxobin group exhibited a greater mean flap survival area, a better microcirculatory flow, and higher-level expression of SOD and VEGF compared with the control group. However, the MDA level was significantly reduced. CONCLUSION: Batroxobin effectively improved the survival of random skin flaps.


Assuntos
Batroxobina/farmacologia , Retalhos Cirúrgicos , Animais , Masculino , Malondialdeído/metabolismo , Microcirculação/efeitos dos fármacos , Neovascularização Fisiológica/efeitos dos fármacos , Ratos Sprague-Dawley , Superóxido Dismutase/metabolismo , Retalhos Cirúrgicos/irrigação sanguínea , Retalhos Cirúrgicos/patologia , Fator A de Crescimento do Endotélio Vascular/metabolismo
6.
Acta Otolaryngol ; 139(6): 522-528, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31008670

RESUMO

BACKGROUND: Intratympanic corticosteroid (IC), intravenous batroxobin (IB) as the treatment for sudden sensorineural hearing loss (SSNHL) has been reported. However, the data on combination therapy (CT) was scarce. OBJECTIVE: The aim of this retrospective study was to compare the efficacy of IC, IB, and CT in the treatment of SSNHL with diabetes. MATERIAL AND METHODS: A total of 212 SSNHL patients with diabetes, who were initially treated within 14 days of onset of disease, were divided into three groups by treatment modality. The hearing recovery was evaluated by the results of pure-tone test after completion of treatment. The prognostic factors, including age, severity of initial hearing loss, duration to onset of treatment, and audiometric curve type, were further compared. RESULTS: There was a significant difference in hearing recovery by the treatment (p < .05). Recovery rates in the CT group were significantly higher in patients with early treatment than with delayed treatment (p = .021). However, duration and recovery rate was not significantly correlated in IC and IB group (p > .05). In patients recieving early treatment, the recovery rate in CT group was significantly higher than that in IC (p = .013) and IB group (p = .029). Regardless of treatment, the recovery rates were higher in patients with flat and ascending audiograms (p < .05). CONCLUSIONS AND SIGNIFICANCE: Patients receiving combined therapy, especially in the early stage of SSNHL, could achieve significantly superior recovery in the treatment of SSNHL with diabetes, compared with those using IC or IB alone.


Assuntos
Corticosteroides/administração & dosagem , Batroxobina/administração & dosagem , Diabetes Mellitus Tipo 2/complicações , Perda Auditiva Neurossensorial/tratamento farmacológico , Perda Auditiva Súbita/tratamento farmacológico , Adulto , Audiometria de Tons Puros/métodos , Distribuição de Qui-Quadrado , China , Estudos de Coortes , Diabetes Mellitus Tipo 2/diagnóstico , Quimioterapia Combinada , Feminino , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Súbita/diagnóstico , Perda Auditiva Súbita/etiologia , Humanos , Injeção Intratimpânica , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
7.
Eur Arch Paediatr Dent ; 20(4): 311-317, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30900152

RESUMO

AIM: To assess the effectiveness of topically-administered haemocoagulase (batroxobin) (HC) following dental extractions in children. DESIGN: Split-mouth design, where either HC (test) or Normal Saline (control) (NS) was administered to children (5-9 years) requiring bilateral extractions of primary molars. Participants were randomised to (i) extraction sequence; (ii) test-solution administered thereafter. OUTCOME MEASURE: time taken (in seconds) for complete cessation of bleeding. RESULTS: Thirty participants completed the trial receiving HS (n = 30) and NS (n = 30). No adverse events were reported. Time to bleeding cessation was lower in HS group (82.5 ± 13.99 s) than NS group (240.5 ± 54.34 s). Difference between groups (paired t test) was statistically very highly significant (P = 0.000). CONCLUSION: Topical HC produced significant reductions in time for haemostasis and was clinically effective in controlling haemorrhage from extraction wounds in children. HC may be favourably utilised by paediatric dentists, especially with pre-cooperative or special-healthcare-needs patients, improving patient care.


Assuntos
Batroxobina , Hemostáticos , Criança , Método Duplo-Cego , Humanos , Boca , Extração Dentária , Dente Decíduo
8.
Acta Otolaryngol ; 139(3): 258-262, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30762471

RESUMO

BACKGROUND: Combination therapy is the first-line option for total-deafness sudden sensorineural hearing loss (SSNHL). Age may act as a crucial prognostic factor. OBJECTIVE: The aim of this study was to compare efficacy of combination therapy between adolescent and adult patients with total-deafness SSNHL. MATERIALS AND METHODS: Twenty-five adolescent patients (adolescent group) and 106 adult patients (adult group) with total-deafness SSNHL were recruited. All the recruited patients underwent initial treatment with batroxobin, methylprednisolone, and gastrodin. After 10-day treatment, hearing outcomes were determined by pure-tone average measured by audiometry. Moreover, the total effective rates in the hearing recovery and improvement of tinnitus were calculated. RESULTS: There existed no significant difference between two groups in the total effective rate of the hearing recovery (p = .110). However, a significant difference was found in the total effective rate of improvement of tinnitus between two groups (p = .016). Both adolescent and adult patients could receive the optimal hearing gains at 500 Hz (20.2 ± 13.3 and 23.1 ± 13.9dB, respectively), followed by those at 1000 Hz (18.8 ± 12.5 and 22.7 ± 14.8dB, respectively). Yet, adult patients could get better hearing gains only at 500 Hz than adolescent patients (p = .02). CONCLUSION: Compared with adult patients, adolescent patients with total-deafness SSNHL undergoing combination therapy may be less likely to have hearing recovery and the improvement of tinnitus.


Assuntos
Anti-Inflamatórios/administração & dosagem , Batroxobina/administração & dosagem , Álcoois Benzílicos/administração & dosagem , Fibrinolíticos/administração & dosagem , Glucosídeos/administração & dosagem , Perda Auditiva Súbita/tratamento farmacológico , Metilprednisolona/administração & dosagem , Adolescente , Fatores Etários , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
J Thromb Thrombolysis ; 46(3): 371-378, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30062617

RESUMO

Cerebral venous sinus thrombosis (CVST) is an uncommon subtype of stroke with highly variable clinical presentation. Although anticoagulation with heparin and/or warfarin remains the standard treatment for CVST, treatment failure is still common. This study aims to evaluate the safety and efficacy of Batroxobin in combination with anticoagulation on CVST control. In this retrospective study, a total of 61 CVST patients were enrolled and divided into Batroxobin (n = 23) and control (n = 38) groups. In addition to the same standard anticoagulation in control, patients in the treatment group received Batroxobin 5 BU intravenous infusion (10 BU for the first time) every other day, for a total of three infusions. A higher recanalization rate was found in Batroxobin group (adjusted OR [95% CI] of 2.5 [1.1-5.0], p = 0.028) compared to the control group, especially in patients with high levels of fibrinogen (adjusted OR [95% CI] of 4.7 [1.4-16.7], p = 0.015). Statistically significant differences between the two groups were seen regarding the levels of thrombin time, fibrinogen and D-dimer at each cut-off time point (all p < 0.01). Compared with baseline, NIHSS scores at discharge showed significant improvement in the Batroxobin group [0(0, 4.25)-5(2, 11), p = 0.036]. No significant difference in mRS scores was found between the two groups at discharge or at 6-month outpatient follow-up (all p > 0.05). Additionally, Batroxobin did not increase the risk of intracranial hemorrhage. We conclude that Batroxobin is a potentially safe and effective adjunct therapeutic agent promoting CVST recanalization especially in patients with high level of fibrinogen.


Assuntos
Anticoagulantes/uso terapêutico , Batroxobina/administração & dosagem , Trombose dos Seios Intracranianos/tratamento farmacológico , Idoso , Batroxobina/farmacologia , Testes de Coagulação Sanguínea , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Fibrinogênio/análise , Hemostáticos/administração & dosagem , Humanos , Hemorragias Intracranianas , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
10.
Clin Drug Investig ; 38(9): 829-835, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29978322

RESUMO

BACKGROUND AND OBJECTIVE: Batroxobin, a snake venom thrombin-like enzyme, converts fibrinogen into fibrin by cleaving fibrinopeptide A. It is used for hemostasis; however, the supply of native batroxobin is limited. Therefore, we developed a recombinant batroxobin (r-batroxobin) from Pichia pastoris and evaluated its pharmacodynamics and safety in humans. METHODS: A randomized, double-blind, placebo-controlled, single ascending-dose study was performed. Eight healthy subjects were enrolled in each r-batroxobin dose group (2.5, 5.0, or 10.0 BU/2.0 mL administered intravenously), and randomized to receive r-batroxobin (n = 6) or matching placebo (n = 2). Safety was evaluated during the study, and pharmacodynamics was assessed using prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), and fibrinogen level. RESULTS: All subjects in each cohort completed the study. No significant changes in PT or aPTT occurred after intravenous r-batroxobin administration. Compared with the placebo group, the fibrinogen level in all r-batroxobin dose groups decreased significantly to 8.68-33.57% from the baseline within 12 h (p ≤ 0.05). The TT in the 5.0 and 10.0 BU/2.0 mL groups significantly increased to 7.53-18.48% from baseline within 12 h compared with that of the placebo group (p ≤ 0.05), whereas that of the 2.5 BU/2.0 mL group exhibited non-significant changes compared with the placebo group. No serious adverse events occurred. CONCLUSIONS: A single intravenous injection of r-batroxobin within a dose range of 2.5-10.0 BU/2.0 mL was well tolerated and resulted in a significant decrease in fibrinogen and prolongation of TT. REGISTRATION: This study is registered at the Clinical Research Information Service (CRIS, http://cris.nih.go.kr ), number KCT0002518.


Assuntos
Batroxobina/administração & dosagem , Batroxobina/sangue , Coagulação Sanguínea/efeitos dos fármacos , Hemostáticos/administração & dosagem , Hemostáticos/sangue , Tempo de Protrombina , Adulto , Coagulação Sanguínea/fisiologia , Estudos de Coortes , Relação Dose-Resposta a Droga , Método Duplo-Cego , Voluntários Saudáveis , Humanos , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Tempo de Protrombina/métodos , Proteínas Recombinantes/administração & dosagem , Trombina/metabolismo , Adulto Jovem
12.
Int J Biol Macromol ; 113: 757-763, 2018 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-29514041

RESUMO

The choice of hemostat is determined by the situation and the degree of hemorrhage. One common hemostat, the nonwoven dressing, is easy to handled and controls severe bleeding on wider wounds. In this study, chitosan-based nonwoven dressings with recombinant batroxobin (rBat) were used as efficacious hemostatic dressing agents. Hemostatic agents need to absorb blood quickly in the early stages of blood coagulation cascade to rapidly and effectively control of excessive hemorrhages. To date, most studies of hemostatic agents focused on a single material and hemostats composed of multiple materials have not been studied sufficiently. Thus, we made a chitosan dressing coated with rBat and investigated the microstructure, mechanical properties, hemostatic efficacy, and clotting properties of the coated dressing. Our results showed that the rBat had a synergetic effect on chitosan that improved blood coagulation. Furthermore, the dressing had excellent bleeding control in an Sprague-Dawley (SD) rat femoral artery hemorrhage model. In conclusion, hemostasis can be improved by combining a chitosan-based nonwoven dressing with other agents, and rBat-coated chitosan-based nonwoven dressings have enormous potential to improve blood coagulation.


Assuntos
Bandagens , Batroxobina/química , Quitosana/química , Quitosana/farmacologia , Hemorragia/tratamento farmacológico , Hemostasia/efeitos dos fármacos , Proteínas Recombinantes/química , Animais , Coagulação Sanguínea/efeitos dos fármacos , Quitosana/uso terapêutico , Artéria Femoral/efeitos dos fármacos , Artéria Femoral/fisiopatologia , Hemorragia/fisiopatologia , Masculino , Ratos , Ratos Sprague-Dawley
13.
Artigo em Chinês | MEDLINE | ID: mdl-29365372

RESUMO

Objective: To analyze the correlation between the changes of fibrinogen and the treatment effect of all-frequency sudden deafness, and to explore the individualized treatment strategy for the use of Batroxobin. Methods: Patients with all-frequency sudden deafness who were admitted to Department of Otorhinolaryngology, People's Hospital of Peking University, from January 2010 to September 2016 were selected. All patients were given standard treatment and regular use of Batroxobin. Value of fibrinogen on D1 (before treatment) / D3 / D7 (±1) and D14 (±2) were recorded, at the same time, the correlation between the changes of fibrinogen and prognosis of all-frequency sudden deafness by the audiograms of onset and after-treatment of all patients were analyzed. Independent t-test was used to analyze normal distributed measurement data and chi square linear trend test was used to analyze the curative effect of different fibrinogen groups. Results: A total of 148 patients were included, the outcomes were worst when the patient's fibrinogen was below 2 g/L or above 4 g/L before treatment, ineffective rate were both 50%. The fibrinogen was lowest when the treatment came to the third day. Normally, the patient's prognosis was best when this value waved between 0.7 and 0.9 g/L, with a total effective rate between 73.9% and 83.3%. The fibrinogen value of the 7th day was a good indicator of the outcome, and Fib7 value was significant lower in patients of effective group than ineffective ones ((1.25±0.37)g/L vs (1.38±0.35) g/L, t=-0.27, P=0.04). Patients found a best recovery when Fib7 was below 1 g/L, and the higher the Fib7 value, the higher the inefficiency (χ(2)=7.55, P=0.01). Batroxobin showed safety during the treatment and found no complications. Conclusion: The change of fibrinogen in the process of all-frequency sudden deafness is closely related to the curative effect.


Assuntos
Batroxobina/farmacologia , Fibrinogênio/efeitos dos fármacos , Fibrinolíticos/farmacologia , Perda Auditiva Súbita/sangue , Perda Auditiva Súbita/tratamento farmacológico , Distribuição de Qui-Quadrado , Fibrinogênio/análise , Testes Auditivos , Humanos , Prognóstico , Fatores de Tempo , Resultado do Tratamento
14.
Spine (Phila Pa 1976) ; 43(5): E267-E273, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28678111

RESUMO

STUDY DESIGN: A prospective randomized double blind placebo controlled trail. OBJECTIVE: To evaluate and compare the efficacy and safety of batroxobin (botropase), tranexamic acid (TXA), and their combination in reduction of perioperative blood loss in lumbar spine single level fusion surgeries. SUMMARY OF BACKGROUND DATA: Spinal surgeries are associated with significant blood loss leading to perioperative anemia and increased need for allogenic transfusion. TXA competitively inhibits plasmin and batroxobin converts fibrinogen to fibrin and theoretically their combination is synergistic. Though TXA is widely studied in controlling blood loss, there is little information on use of batroxobin and their combination. Thus, we aimed to study effect and safety of individual drugs and their combination in controlling blood loss in spinal surgery. METHODS: Hundred patients were randomized into four groups. Group B received batroxobin, group T received TXA, group BT received batroxobin and TXA and group P received placebo. Outcomes assessed are intraoperative and postoperative blood loss, hematocrit, allogenic blood transfusion, and deep vein thrombosis (DVT), postoperatively. RESULT: Mean intraoperative blood loss in Group B, T, BT, and P were 268.32 ±â€Š62.92 mL, 340.72 ±â€Š182.75 mL, 256.96 ±â€Š82.64 mL, and 448.44 ±â€Š205.86 mL, respectively. Postoperative surgical site drain collection in Group B, T, BT, and P were 218.00 ±â€Š100.54 mL, 260.40 ±â€Š100.85 mL, 191.00 ±â€Š87.84 mL, and 320.00 ±â€Š125.83 mL, respectively. Intraoperative blood loss of Group P was statistically higher than Groups B and BT (P < 0.001). Mean postoperative surgical site drain collection was statistically significant (P < 0.001). No statistically significant differences in fluid administration (P = 0.751), blood transfusion (P = 1.000), preoperative and postoperative hemoglobin (P = 0.090, P = 0.134, respectively), and deep vein thrombosis (P = 1.000). CONCLUSION: Batroxobin and combination of batroxobin with tranexamic acid significantly reduced perioperative blood loss when compared with placebo. LEVEL OF EVIDENCE: 2.


Assuntos
Antifibrinolíticos/administração & dosagem , Batroxobina/administração & dosagem , Perda Sanguínea Cirúrgica/prevenção & controle , Vértebras Lombares/cirurgia , Fusão Vertebral/efeitos adversos , Ácido Tranexâmico/administração & dosagem , Adulto , Idoso , Transfusão de Sangue/tendências , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/diagnóstico , Hemorragia Pós-Operatória/prevenção & controle , Estudos Prospectivos , Fusão Vertebral/tendências , Resultado do Tratamento
15.
Curr Med Chem ; 24(17): 1874-1891, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28578650

RESUMO

Snakes are fascinating creatures and have been residents of this planet well before ancient humans dwelled the earth. Venomous snakes have been a figure of fear, and cause notable mortality throughout the world. The venom constitutes families of proteins and peptides with various isoforms that make it a cocktail of diverse molecules. These biomolecules are responsible for the disturbance in fundamental physiological systems of the envenomed victim, leading to morbidity which can lead to death if left untreated. Researchers have turned these life-threatening toxins into life-saving therapeutics via technological advancements. Since the development of captopril, the first drug that was derived from bradykininpotentiating peptide of Bothrops jararaca, to the disintegrins that have potent activity against certain types of cancers, snake venom components have shown great potential for the development of lead compounds for new drugs. There is a continuous development of new drugs from snake venom for coagulopathy and hemostasis to anti-cancer agents. In this review, we have focused on different snake venom proteins / peptides derived drugs that are in clinical use or in developmental stages till to date. Also, some commonly used snake venom derived diagnostic tools along with the recent updates in this exciting field are discussed.


Assuntos
Venenos de Serpentes/química , Animais , Anticoagulantes/química , Anticoagulantes/metabolismo , Anticoagulantes/uso terapêutico , Batroxobina/química , Batroxobina/uso terapêutico , Coagulação Sanguínea/efeitos dos fármacos , Captopril/química , Captopril/uso terapêutico , Peptídeos/metabolismo , Peptídeos/farmacologia , Peptídeos/uso terapêutico , Venenos de Serpentes/metabolismo , Serpentes/metabolismo , Trombose/tratamento farmacológico , Trombose/patologia , Tirofibana , Toxinas Biológicas/metabolismo , Toxinas Biológicas/farmacologia , Toxinas Biológicas/uso terapêutico , Tirosina/análogos & derivados , Tirosina/química , Tirosina/uso terapêutico
16.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 39(2): 183-187, 2017 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-28483015

RESUMO

Objective To evaluate the hemostatic effect of hemocoagulase agkistrodon on surgical wound in breast cancer surgery. Methods Totally 60 patients undergoing breast cancer surgery were enrolled in this prospective,randomized,double-blinded,and controlled study. All the patients met the inclusion and exclusion criteria and signed the informed consent. Hemocoagulase agkistrodon (2 U) was injected 20 minutes before surgery and 4 and 24 hours after surgery in the intervention group (n=30),whereas normal saline was used instead in the control group (n=30). The volume of intraoperative bleeding,wound drainage volume 1-3 days after surgery,and total drainage volume were recorded. Meanwhile,the change of blood coagulation function,treatment safety,and clinical outcomes were observed. Results The intra-operative hemorrhage volume of the intervention group [(95.0±48.3)g] was significantly lower than that of the control group [(144.8±105.4)g] (t=-2.07,P=0.044). The volume of total drainage of the intervention group [(166.7±71.2)g] was significantly lower than that of the control group [(251.4±166.3)g] (t=-2.29,P=0.029). The hemoagglutination indicators were similar in the two groups and no complication such as thrombosis occurred. The length of hospital stay of the intervention group [(15.00±3.53)d] was similar to that of the control group [(15.92±2.32)d] (t=-1.057,P=0.297). No research drug-related adverse event was occurred in our study. Conclusion Hemocoagulase agkistrodon has good hemostatic effect for patients undergoing breast cancer surgery without increasing the risk of thrombosis.


Assuntos
Agkistrodon , Batroxobina/uso terapêutico , Neoplasias da Mama/cirurgia , Hemostáticos/uso terapêutico , Ferida Cirúrgica/tratamento farmacológico , Animais , Método Duplo-Cego , Feminino , Humanos , Estudos Prospectivos
17.
Ultrasound Med Biol ; 43(8): 1658-1670, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28545858

RESUMO

We investigated a new method for combining microbubble-enhanced ultrasound cavitation (MEUC) with hemocoagulase (HC) atrox. Our goal was to induce embolic effects in the vasculature and combine these with an anti-angiogenic treatment strategy. Fourteen days after being implanted with a single slice of the liver VX2 tumor, rabbits were randomly divided into five groups: (i) a control group injected intra-venously with saline using a micropump; (ii) a group given only an injection of HC; (iii) a group treated only with ultrasound cavitation; (iv) a group treated with MEUC; (v) a group treated with MEUC + HC. Contrast-enhanced ultrasound was performed before treatment and 1 h and 7 d post-treatment to measure tumor size, enhancement and necrosis range. QontraXt software was used to determine the time-intensity curve of tumor blood perfusion and microvascular changes. At 1 h and 7 d after treatment with MEUC + HC, the parameters of the time-intensity curve, which included peak value, regional blood volume, regional blood flow and area under the curve value and which were measured using contrast-enhanced ultrasound, were significantly lower than those of the other treatment groups. The MEUC + HC treatment group exhibited significant growth inhibition relative to the ultrasound cavitation only, HC and MEUC treatment groups. No damage was observed in the surrounding normal tissues. These results support the feasibility of reducing the blood perfusion of rabbit VX2 liver tumors using a new method that combines MEUC and HC.


Assuntos
Batroxobina/administração & dosagem , Meios de Contraste , Aumento da Imagem/métodos , Neoplasias Hepáticas/terapia , Microvasos , Terapia por Ultrassom/métodos , Animais , Modelos Animais de Doenças , Feminino , Fígado/diagnóstico por imagem , Masculino , Microbolhas , Coelhos , Ultrassonografia de Intervenção/métodos
18.
Am J Case Rep ; 18: 291-293, 2017 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-28325889

RESUMO

BACKGROUND In patients with large colon polyps, late-onset bleeding may be more likely to occur because of the larger cutting surface. In these patients, hemostatic agents may be applied to prevent the late-onset bleeding. A total of 7 patients developed hypofibrinogenemia caused by hemocoagulase following excision of colon polyps in our center from November to December 2015. CASE REPORT Seven patients underwent excision of colon polyps in our center from November to December 2015. The cutting face was large in these patients after surgery; therefore, hemocoagulase was used to prevent potential late-onset bleeding. Evaluation of clotting function showed that the fibrinogen level was normal before surgery in all 7 patients. Hemocoagulase was intravenously administered twice daily beginning from postoperative day 1. Hypofibrinogenemia of varying severity occurred 2-4 d later. Three patients also had lower-gastrointestinal bleeding. After drug withdrawal and infusion of fibrinogen, blood fibrinogen level gradually returned to normal. In contrast, among 13 patients who had not received hemocoagulase treatment for preventing hemorrhage following excision of colon polyps, detection of blood fibrinogen before surgery and 2-4 d after showed normal results. CONCLUSIONS Routine use of Hemocoagulase For Injection for the prevention of late-onset bleeding is not recommended for patients who have undergone excision of colon polyps. Hemocoagulase following excision of colon polyps can cause hypofibrinogenemia and even lower-gastrointestinal bleeding.


Assuntos
Afibrinogenemia/induzido quimicamente , Batroxobina/efeitos adversos , Pólipos do Colo/cirurgia , Hemostáticos/efeitos adversos , Hemorragia Pós-Operatória/prevenção & controle , Batroxobina/administração & dosagem , Hemorragia Gastrointestinal/etiologia , Hemostáticos/administração & dosagem , Humanos
19.
Ren Fail ; 39(1): 414-416, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28330422

RESUMO

Rectus sheath hematomas (RSHs) are uncommon. They are usually unilateral and rarely bilateral. In this paper, we report the first case of spontaneous bilateral RSHs in a uremic patient after the administration of the first dose of low-molecular weight heparin during hemodialysis. The most interesting aspect of this case is that the main symptom of RSH in our patient was urinary bladder irritation. We highlight the importance of the prompt diagnosis and management of this medical emergency.


Assuntos
Anticoagulantes/efeitos adversos , Hematoma/induzido quimicamente , Heparina de Baixo Peso Molecular/efeitos adversos , Diálise Renal/efeitos adversos , Uremia/terapia , Dor Abdominal/diagnóstico , Dor Abdominal/etiologia , Administração Intravenosa , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Batroxobina/administração & dosagem , Batroxobina/uso terapêutico , Transfusão de Componentes Sanguíneos , Hematoma/diagnóstico por imagem , Hematoma/terapia , Hemostáticos/administração & dosagem , Hemostáticos/uso terapêutico , Heparina de Baixo Peso Molecular/administração & dosagem , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Hiperpotassemia/sangue , Hiperpotassemia/terapia , Masculino , Pessoa de Meia-Idade , Plasma , Reto do Abdome/patologia , Diálise Renal/métodos , Trombose/prevenção & controle , Tomografia Computadorizada por Raios X , Ultrassonografia , Uremia/sangue , Doenças da Bexiga Urinária/diagnóstico por imagem , Doenças da Bexiga Urinária/etiologia
20.
Injury ; 48(4): 914-919, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28238301

RESUMO

BACKGROUND: Uncontrolled bleeding is associated with poor outcomes and mortality in geriatric patients undergoing hemiarthroplasty. Hemocoagulase agkistrodon is a hemocoagulative, anti-hemorrhagic enzyme complex from Deinagkistrodon acutus snake venom. This study aimed to investigate the efficacy of hemocoagulase agkistrodon on coagulation and bleeding outcomes in fracture-related hemiarthroplasty. PATIENTS AND METHODS: This was a prospective, single-blinded, randomized controlled trial carried out between October 2013 and September 2014 in 96 geriatric patients undergoing hemiarthroplasty for unilateral femoral neck fracture. Patients were administrated hemocoagulase agkistrodon (n=48) or normal saline (n=48). Intraoperative blood loss, transfusion volume and rate, and drainage were assessed. Hemoglobin (Hb) and coagulation parameters (prothrombin time [PT], thrombin time [TT], plasma fibrinogen [FIB], and activated partial thromboplastin time [aPTT]) were recorded preoperatively and 30min and 1, 3, and 5days after surgery. Complications were followed up for 4 weeks. RESULTS: Compared to controls, hemocoagulase patients exhibited lower intraoperative blood loss (P<0.01) and postoperative blood loss, total drainage, mean transfusion volume, and transfusion rates (all P<0.05), with lower aPTT at 30min (P<0.05). No significant differences in postoperative FIB were observed. Controls exhibited significantly higher PP and TT on day 1, and Hb on days 1, 3, and 5 (P<0.05). No serious complications were reported. CONCLUSIONS: Hemocoagulase reduced blood loss and transfusion in fracture-related hip hemiarthroplasty without increasing short-term adverse event rates. In geriatric populations, hemocoagulase could be used for limiting bleeding and related complications. TRIAL REGISTRATION: This trial is registered in the Chinese Clinical Trial Register (no. ChiCTR-TRC-14004379).


Assuntos
Batroxobina/administração & dosagem , Coagulação Sanguínea , Perda Sanguínea Cirúrgica/prevenção & controle , Transfusão de Sangue/estatística & dados numéricos , Fraturas do Colo Femoral/complicações , Hemiartroplastia/métodos , Hemostáticos/administração & dosagem , Administração Intravenosa , Idoso , Idoso de 80 Anos ou mais , Batroxobina/farmacologia , Coagulação Sanguínea/efeitos dos fármacos , Testes de Coagulação Sanguínea , China/epidemiologia , Feminino , Fraturas do Colo Femoral/mortalidade , Fraturas do Colo Femoral/cirurgia , Serviços de Saúde para Idosos , Hemiartroplastia/efeitos adversos , Hemiartroplastia/mortalidade , Hemostáticos/farmacologia , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento
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