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1.
Zhongguo Gu Shang ; 33(1): 53-8, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32115925

RESUMO

OBJECTIVE: To explore the hemostatic effect of absorbable hemostatic fluid gelatin in single anterior cervical subtotal corpectomy and decompression fusion (ACCF) . METHODS: From August 2014 to February 2018, 44 patients with single anterior cervical corpectomy decompression and fusion were selected and divided into two groups:22 cases in experimental group including 10 males and 12 females with an average age of (55.6±9.7) years old, were treated by hemostasis with absorbable hemostasis fluid gelatin; 22 cases in control group including 11 males and 11 females with an average age of (54.4± 11.1) years old were treated by hemostasis with traditional hemostasis method. The operation time, decompression time, intraoperative hemorrhage, postoperative negative pressure drainage, postoperative neurological improvement rate (JOA%) , postoperative bone fusion time, postoperative titanium mesh subsidence rate, postoperative hematoma and other postoperative complications were compared between the two groups. RESULTS: The operative time of the experimental group (83.1±19.2) min was significantly shorter than that of the control group (89.5±17.0) min (P<0.05) ; the decompression time of the spinal canal in the two groups was (52.4±13.7) , (56.1±14.6) min, with a statistically significant difference (P=0.001) ; the amount of bleeding in the two groups was (49.9±12.4) , (90.6±36.7) ml, with a statistically significant difference (P<0.05) ; the total amount of drainage in the negative pressure drainage ball after operation in the two groups was (42.5±18.3) , (60.0±22.8) ml, the difference was statistically significant (P<0.05) . There was no statistically significant difference in the improvement rate of nerve function between the two groups at 1 week after operation, and the improvement rate of nerve function in the experimental group was better than that in the control group at 3 and 6 months after operation. In the two groups, bone fusion was obtained 6 months after operation, no obvious titanium mesh subsidence was found in 3 months after operation, no acute hematoma, CSF leakage and other postoperative complications were found. CONCLUSION: Absorbable hemostatic fluid gelatin has a significant hemostatic effect in ACCF operation, can maintain a good operation field, can reduce the decompression time of spinal canal, reduce the amount of bleeding during operation and the amount of bleeding after operation. It is a more effective and safe hemostatic material than the traditional hemostatic method.


Assuntos
Hemostáticos , Adulto , Idoso , Vértebras Cervicais , Descompressão Cirúrgica , Feminino , Gelatina , Hemostasia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
2.
Sheng Wu Gong Cheng Xue Bao ; 36(2): 332-340, 2020 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-32148005

RESUMO

In order to further improve the hemostatic performance of wound dressings, human platelet-rich plasma (PRP) containing various growth factors was introduced into chitosan solution. The silk fibroin solutions with different volume ratios (1:1, 1:3, 3:1 and 1:0) were added to improve the porosity and hemostasis of materials. The hPRP-chitosan/silk wound dressings with different ratios was prepared by freeze-drying and pure chitosan dressing was considered as the control group to study the effects of PRP and silk fibroin in different proportions on the hemostasis properties and the growth factors burst release. The hemostasis of chitosan dressing was improved by introducing PRP, but the porous structure and water absorption were not significantly improved. If silk fibroin solution was added in the ratio of 1:1, the more uniform porous structure and better hemostatic performance could be obtained. The porosity and water absorption could reach 86.83%±3.84% and 1 474%±114% respectively. In addition, the dressings with ratio of 1:1 had positive effects on reducing the burst release of growth factors on initial stage. Therefore, PRP-chitosan/silk fibroin composite dressing can become a kind of wound dressing that can achieve rapid hemostasis and promote wound healing.


Assuntos
Bandagens , Hemostáticos , Quitosana , Fibroínas , Hemostasia , Humanos , Plasma Rico em Plaquetas , Porosidade
4.
Orv Hetil ; 161(7): 252-262, 2020 Feb.
Artigo em Húngaro | MEDLINE | ID: mdl-32037866

RESUMO

Introduction: During liver transplantation, haemostasis is typically assessed by means of standard laboratory tests and viscoelastic tests, while dynamic monitoring of coagulation factor specific blood losses is an unusual, yet established approach. Aim: Our aim was to evaluate the volume-based haemostasis reserves in blood product free liver transplants in the first perioperative 48 hours, in association with the Child-Pugh score. Method: Data of 59 blood product free liver transplanted patients' coagulation factor levels, viscoelastic parameters and coagulation factor specific blood losses according to Gross methodological, baseline and 'coagulopathic' trigger levels were analysed. The haemostasis reserves were estimated according to the Child-Pugh classification. Laboratory tests and the calculation of haemostasis reserves were carried out before liver transplantation (T1), at the end of the surgery (T2) and also 12-24-48 hours postoperatively (T3-T4-T5). The viscoelastic tests were performed before liver transplantation (T1) and at the end of the surgery (T2). Results: Fibrinogen levels decreased by 1.2 g/L. Factor II, V, VII, X levels decreased by 26-40%. From T2 to T4, fibrinogen increased by 0.9 ± 0.6 g/L over 24 h (p<0.001). Factor II, V, VII, X levels increased by 12-30% between T3 to T5 (p<0.001). The viscoelastic parameters remained in the normal range during liver transplantation (T1-T2). Haemostasis reserves decreased by 61% at the end of surgery (p<0.001), but reached 88% of the preoperative value on the second postoperative day. The initial reserves of Child B and C groups were 36-41% lower than Child A, nevertheless, these differences were not significant at 48 hours. Conclusion: The volume-based haemostasis approach supplements the standard laboratory and viscoelastic tests. This unusual approach dynamically indicates the actual reserve of haemostasis and shows the 'weakest link' within the system. Orv Hetil. 2020; 161(7): 252-262.


Assuntos
Hemostasia , Transplante de Fígado , Testes de Coagulação Sanguínea , Fibrinogênio/metabolismo , Humanos
6.
Anaesthesia ; 75(3): 366-373, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31845321

RESUMO

Coagulopathic bleeding during and after cardiac surgery is associated with increased morbidity and mortality. Viscoelastic testing is increasingly used instead of laboratory testing. Our aim was to compare a new viscoelastic point-of-care device, the Quantra® System, with thromboelastography and standard laboratory testing. After ethical approval and with written informed consent, we prospectively recruited adult patients undergoing urgent cardiac surgery at increased risk of bleeding. Clot time and clot stiffness values were compared before, during and after cardiopulmonary bypass. We prospectively recruited 52 patients, of whom 34 (65%) were transfused with red blood cells. Our usual transfusion thresholds for fibrinogen (1.5 g.l-1 ), platelets (100,000.µl-1 ), prothrombin time (20 s), activated partial thromboplastin time (48 s) and maximum amplitude on thromboelastography (50 mm) corresponded to Quantra values of fibrinogen clot stiffness 2.0 hPa, platelet clot stiffness 13.5 hPa, clot time 159 s, clot time 183 s and clot stiffness 17.0 hPa, respectively. These Quantra thresholds showed high negative predictive value for low platelets (platelet clot stiffness, 97.4%), prolonged activated partial thromboplastin time (clot time, 92.6%) and reduced maximum amplitude on thromboelastography (clot stiffness, 93.6%). The Quantra predicted clinical need for transfusion of platelets (area under the curve 0.71, p = 0.001) but all tests performed poorly at predicting the need for fresh frozen plasma transfusion. We have shown that point-of-care testing using the novel Quantra system provides useful data for guiding transfusion management.


Assuntos
Transfusão de Sangue/instrumentação , Procedimentos Cirúrgicos Cardíacos/métodos , Hemostasia , Testes Imediatos , Tromboelastografia/métodos , Idoso , Idoso de 80 Anos ou mais , Testes de Coagulação Sanguínea , Viscosidade Sanguínea , Estudos de Coortes , Elasticidade , Serviços Médicos de Emergência , Transfusão de Eritrócitos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plasma , Transfusão de Plaquetas , Valor Preditivo dos Testes , Estudos Prospectivos
7.
Artigo em Russo | MEDLINE | ID: mdl-31793543

RESUMO

AIM: To detect plasma procoagulant activity in patients with schizophrenia at admission to the hospital in a state of exacerbation before (point 1) and after (point 2) pharmacotherapy and evaluate plasma and platelet hemostasis abnormalities. MATERIAL AND METHODS: The study included 80 women, aged from 16 to 57 years, median age 28 years, with schizophrenia with continuous, paroxysmal-progressive or paroxysmal course (F20.00, F20.01, F20.02 according to ICD-10). In 42 of 80 patients, depressive disorders in the structure of schizophrenia were observed. The thrombodynamic test (TD) was performed on T-2 Trombodynamis device according to the manufacturer's instructions (Hemacore LLC, Moscow, Russia). Blood for the TD test was taken in admission to the hospital (point 1) and on discharge (point 2). All patients received standard pharmacotherapy according to their condition. RESULTS: For the first time, it was established that in the whole group of patients (n=46) thrombodynamic indicators of the rate of growth of the clot: initial velocity (Vin), stationary velocity (Vst) and adjusted for spontaneous clots velocity (V) and the amount of clot for 30 minutes test TD (ClotSize, CS) were significantly higher compared to normal values. The mean time of occurrence of spontaneous thrombosis (Tsp) was significantly less than 30 min (p<0.0001), indicating rapid, spontaneous thrombosis. Other parameters of TD did not differ significantly from the norm. As a result of treatment, the initial growth rate of the clot from the activator (Vi) decreased from 58,5 µm/min to 54,5 µm/min; V speed from 37,4 µm/min to 33,5 µm/min; CS clot size from 1249 µm to 1219 µm; clot density - from 24 874 units up to 23 658 units. All these changes are significant. Such dynamics of plasma hemostasis clearly indicates a significant decrease in the coagulation activity of the blood plasma of patients as a result of treatment. An increase in the time of appearance of spontaneous clots after treatment (from 23.5 minutes to 30.5 minutes) indicates a decrease in the procoagulant activity of platelet microparticles after treatment, i.e. the reduction of platelet activation as a result of treatment. CONCLUSION: Our studies have shown for the first time that treatment of patients with antidepressants and antipsychotics reduces the generation of spontaneous clots. The treatment of patients with schizophrenia is accompanied by a decrease in the activity of plasma and platelet hemostasis. This is of great practical importance, since hypercoagulation of spontaneous clots in schizophrenic patients aggravates their chronic inflammatory disorders and affects their resistance to treatment.


Assuntos
Transtornos da Coagulação Sanguínea , Coagulação Sanguínea , Esquizofrenia , Adolescente , Adulto , Antipsicóticos/efeitos adversos , Coagulação Sanguínea/efeitos dos fármacos , Transtornos da Coagulação Sanguínea/induzido quimicamente , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Feminino , Hemostasia , Humanos , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Adulto Jovem
8.
Artigo em Russo | MEDLINE | ID: mdl-31825379

RESUMO

The paper presents the author's analysis of the main trends in the development of modern neuroanesthesiology over the past five to ten years. These, in the author\s opinion, include the introduction and elaboration of blood-sparing techniques, monitoring the depth of anesthesia, fast track concept, applying regional (conduction) anesthesia techniques, xenon anesthesia, development of effective and safe protocols for DVT and PTE prophylaxis for neurosurgical patients, study of the hemostatic system using bedside methods for assessing hemostasis (thromboelastogram) and correcting hypocoagulation by activated recombinant VII factor.


Assuntos
Anestesia por Condução , Anestesiologia , Hemostáticos , Hemostasia , Humanos , Procedimentos Neurocirúrgicos
9.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3842-3860, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31872715

RESUMO

Zhigancao decoction recorded in Treatise on Febrile Disease by Zhang Zhongjing in the Han dynasty have been widely used in treating palpitation and irregular pulse by traditional Chinese medicine physicians for thousands of years. It is all known that Zhigancao Decoction is used to treat consumptive disease. However,why it has been used to treat exogenous febrile disease? According to studies,Fumai Decoctions in Treatise on Differentiation and Treatment of Epidemic Febrile Disease,that was modified based on Zhigancao Decoction,have their names without reality. Serious defects,including unclear diagnosis,curative effect,and prognosis,have been found in ancient and modern medical records about Zhigancao Decoction. The indications of Zhigancao Decoction include atrial premature beats,ventricular premature beats,and viral myocarditis; tachyarrhythmia( supraventricular tachycardia,atrial fibrillation)with long interval or conduction block,during or after severe infection or high fever; chronic consumptive disease due to tumor after radiotherapy and chemotherapy,malignant fluid state of tumor,hematopathy,terminal stage of heart failure after major operation,and acute hemorrhage after control of severe infection and other major diseases; cough,phlegm and asthma due to chronic obstructive pulmonary disease,pulmonary interstitial fibrosis,lung cancer,after lung cancer surgery; increased heart rate and decreased blood pressure due to insufficient capacity after acute blood loss; the symptoms included palpitation,chest tightness,sweating,lassitude,lacking in strength,shortness of breath,syncope,sudden death,cough,expectoration,excessive phlegm,clear and dilute sputum,emaciation,dry and haggard skin,constipation,haemorrhagic,uterine bleeding,enjoy sweet taste,red tongue without moss,knotted pulse,intermittent pulse,thready rapid pulse,and weak pulse. Besides,Zhigancao Decoction has effect on cardioversion and maintenance of sinus rhythm without thrombosis in persistent atrial fibrillation and permanent atrial fibrillation. Zhigancao Decoction could stop bleeding soon for acute upper gastrointestinal bleeding,and achieve positivity of occult blood test; Zhigancao Decoction could promote thrombocytopenia for idiopathic thrombocytopenic purpura,with the number of platelets 1×109/L. Zhigancao Decoction could promote the rise of granulocytic,erythroid and megakaryocytic hematopoietic lines in unexplained severe anemia,thrombocytopenia,and leukocyte reduction. Zhigancao Decoction could treat cough,asthma,and chest tightness in lung cancer and after lung cancer surgery; chronic consumptive disease due to lung cancer after lung cancer surgery,hematopathy and acute blood loss,which all belonged to the scope of consumptive disease. Zhigancao Decoction could ascend platelets,which was considered as " oriental interleukins" for the ancients. Zhigancao Decoction possesses dual-directional regulation on anticoagulant and hemostasis,which was considered as " oriental low molecular heparin" and " oriental proton pump inhibitors". Large dose of Rehmannia glutinosa is the key of the efficacy of Zhigancao Decoction. This study is expected to enrich the guidelines for modern medical diagnosis and treatment. However,the clinical evidence,relevant genes and targeting network need to be deepened in future studies. In conclusion,it may be a shortcut to restore and explain Zhigancao Decoction formula syndromes based on modern pathophysiology and severe cases of critical care.


Assuntos
Arritmias Cardíacas/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Cardioversão Elétrica , Plaquetas/citologia , Cuidados Críticos , Hemostasia , Humanos , Fitoterapia , Contagem de Plaquetas , Resultado do Tratamento
10.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(11): 103-108, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31851180

RESUMO

Platelets are an easily accessible model for the study of biochemical mechanisms of mental diseases, including schizophrenia and depression. This literature review addresses a role of platelet activation in the pathogenesis of mental diseases. Platelet activation observed in patients with schizophrenia, depression and other mental illnesses is associated with the development of cardiovascular disease and an increased risk of thrombotic complications, which can be the main cause of morbidity and mortality in patients with mental disorders. A deeper understanding of the biochemical mechanisms of mental disorders will help in the study of clinical consequences of these disorders and in choosing the right therapeutic strategy for patients.


Assuntos
Transtornos Mentais , Ativação Plaquetária , Trombose , Plaquetas , Fibrinólise , Hemostasia , Humanos , Transtornos Mentais/complicações , Transtornos Psicóticos/complicações , Trombose/complicações
12.
Comput Biol Chem ; 83: 107148, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31751883

RESUMO

The field of thrombosis and hemostasis is crucial for understanding and developing new therapies for pathologies such as deep vein thrombosis, diabetes related strokes, pulmonary embolisms, and hemorrhaging related diseases. In the last two decades, an exponential growth in studies related to fibrin clot formation using computational tools has been observed. Despite this growth, the complete mechanism behind thrombus formation and hemostasis has been long and rife with obstacles; however, significant progress has been made in the present century. The computational models and methods used in this context are diversified into different spatiotemporal scales, yet there is no single model which can predict both physiological and mechanical properties of fibrin clots. In this review, we list the major strategies employed by researchers in modeling fibrin clot formation using recent and existing computational techniques. This review organizes the computational strategies into continuum level, system level, discrete particle (DPD), and multi-scale methods. We also discuss strengths and weaknesses of various methods and future directions in which computational modeling of fibrin clots can advance.


Assuntos
Simulação por Computador , Fibrina/metabolismo , Fibrina/química , Hemostasia , Humanos , Trombose
13.
Blood ; 134(19): 1566-1568, 2019 11 07.
Artigo em Inglês | MEDLINE | ID: mdl-31698423

Assuntos
Hemostasia , Cininas
14.
J Physiol Pharmacol ; 70(3)2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31566190

RESUMO

The aim of the study was to evaluate the effect of an active metabolite of losartan - EXP3174 - on a performed venous thrombus in hypertensive rat. The contribution of coagulation and fibrinolytic systems as well as platelets in the EXP3174 action was also determined. Male Wistar rats with renovascular hypertension (2K1C) were used in the study. Stasis-induced venous thrombus was allowed to age for 7 hours before intravenous injection of EXP3174 (10 mg/kg and 30 mg/kg). Thrombus reduction was then evaluated as the difference in thrombus weight 1 hour after drug or its vehiculum administration (8 h-aged thrombus). Euglobulin clot lysis time (ECLT), overall hemostasis potential (OHP), overall coagulation potential (OCP), the time to fibrin generation (TFG), and thrombin amidolytic activity were measured in blood. Collagen-induced platelet aggregation was measured in whole blood. Bleeding time (BT) and systolic blood pressure (SBP) were measured 1 hour after drug administration. EXP3174 in hypotensive doses caused a marked, dose-dependent decrease in venous thrombus weight. Shortened ECLT and decreased OCP, OHP and thrombin amidolytic activity were also observed. Platelet aggregation was significantly decreased after a higher dose of EXP3174, while no changes in BT were observed. Our study provides evidence for reduction of the weight of a formed venous thrombus by losartan metabolite - EXP3174 - in the mechanism involving enhancement of plasma fibrinolytic activity as well as reduced platelet reactivity and coagulation inhibition in 2K1C hypertensive rats.


Assuntos
Anti-Hipertensivos/farmacologia , Hipertensão Renovascular/tratamento farmacológico , Losartan/metabolismo , Trombose/tratamento farmacológico , Trombose Venosa/tratamento farmacológico , Animais , Anti-Hipertensivos/metabolismo , Coagulação Sanguínea/efeitos dos fármacos , Plaquetas/efeitos dos fármacos , Plaquetas/metabolismo , Pressão Sanguínea/efeitos dos fármacos , Hemostasia/efeitos dos fármacos , Hipertensão Renovascular/metabolismo , Losartan/farmacologia , Masculino , Agregação Plaquetária/efeitos dos fármacos , Ratos , Ratos Wistar , Trombose/metabolismo , Trombose Venosa/metabolismo
15.
Carbohydr Polym ; 226: 115304, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31582069

RESUMO

Medicinal herb Bletilla striata as a traditional Chinese herb has been used to treat alimentary canal mucosal damage, ulcers, bruises, and burns for thousands of years. Despite numerous efforts directed at the development of Bletilla striata products, the challenge of preparing Bletilla striata hemostasis dressings while simultaneously maintaining portability and high hemostasis performance has not yet been addressed. Herein, we describe a Bletilla striata polysaccharide (BSP) sponge with hierarchical aligned porous channels formed via directional freeze technology. The microstructure and mechanical property of the BSP sponges could be controlled by modifying the BSP concentration. Notably, in vivo animal studies indicated that BSP sponges show high biocompatibility and degradation and possess excellent hemostasis capability. In addition, BSP sponges showed accelerated wound healing in comparison to commercial dressings. Thus, our study indicates that the constructed BSP sponges could find potential application in dressings for efficient wound healing.


Assuntos
Medicamentos de Ervas Chinesas/farmacologia , Orchidaceae/metabolismo , Plantas Medicinais/metabolismo , Polissacarídeos/farmacologia , Animais , Bandagens , Materiais Biocompatíveis/farmacologia , Feminino , Hemostasia/efeitos dos fármacos , Masculino , Camundongos Endogâmicos C57BL , Coelhos , Cicatrização
16.
BMC Surg ; 19(1): 147, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640661

RESUMO

BACKGROUND: We aimed to determine the optimal bipolar electrocoagulation power for laparoscopic surgery and to investigate which method, bipolar electrocoagulation, advanced bipolar, or ultrasonic technique was more reliable. METHODS: Goat mesenteric vessels (210 in vivo samples) with diameters of 3.03-5.44 mm were selected. Bipolar electrocoagulation with 80 W, 75 W, 70 W, 65 W, 60 W, 55 W, and 50 W, and advanced bipolar and ultrasonic techniques were performed on mesenteric vessels. The thermal damage width, hemostatic effect, and burst pressure of these tissues were recorded. SPSS version 13.0 was used for all data analysis. RESULTS: The results showed that 60 W was the optimal for bipolar electrocoagulation based on the thermal damage width, hemostatic effect, and burst pressure. In contrast, the thermal damage width of advanced bipolar and ultrasonic techniques was smaller than that of bipolar electrocoagulation, and advanced bipolartechnique had the highest successful rate for hemostasis and highest burst pressure. CONCLUSIONS: Bipolar electrocoagulation was optimally performed with 60 W of power. Compared with ultrasonic and bipolar electrocoagulation techniques, advanced bipolar use was more reliable for mesenteric vessels in laparoscopic surgery; however, bipolar electrocoagulation with optimal power can be used for its simplicity of operation and low cost.


Assuntos
Eletrocoagulação/métodos , Hemostasia Cirúrgica/métodos , Laparoscopia/métodos , Animais , Cabras , Hemostasia , Humanos
17.
Arq Bras Cir Dig ; 32(3): e1454, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644674

RESUMO

BACKGROUND: Percutaneous biliary drainage is a safe procedure. The risk of bleeding complications is acceptable. Frequently, patients with biliary obstructions usually have coagulation disorders thus increasing risk of bleeding. For this reason, patients should always fit the parameters of hemostasis. AIM: To determine whether the percentage of bleeding complications in percutaneous biliary drainage is greater in adults with corrected hemostasis prior to the procedure regarding those who did not require any. METHODS: : Prospective, observational, transversal, comparative by independent samples (unpaired comparison). Eighty-two patients with percutaneous biliary drainage were included. The average age was 64±16 years (20-92) being 38 male and 44 female. Patients who presented altered hemostasis were corrected and the presence of bleeding complications was evaluated with laboratory and ultrasound. RESULTS: Of 82 patients, 23 needed correction of hemostasis. The approaches performed were: 41 right, 30 left and 11 bilateral. The amount of punctures on average was 3±2. There were 13 (15.8%) bleeding complications, 12 (20%) in uncorrected and only one (4.34%) in the corrected group with no statistical difference. There were no differences in side, number of punctures and type of drainage, but number of passes and the size of drainage on the right side were different. There was no related mortality. CONCLUSION: Bleeding complications in patients requiring hemostasis correction for a percutaneous biliary drainage was not greater than in those who did not require any.


Assuntos
Perda Sanguínea Cirúrgica , Colestase/cirurgia , Drenagem/efeitos adversos , Hemostasia , Complicações Intraoperatórias/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cateteres , Colestase/sangue , Estudos Transversais , Drenagem/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Punções , Fatores de Risco , Adulto Jovem
19.
Kardiologiia ; 59(10): 14-22, 2019 Oct 14.
Artigo em Russo | MEDLINE | ID: mdl-31615384

RESUMO

PURPOSE: to study distribution of genes of the coagulation system, unfavorable in relation to the risk of thrombosis, and their influence on serum parameters ofthe hemostasis system in patients with nonobstructive coronary atherosclerosis (NCA) and acute coronary syndrome (ACS). MATERIALS AND METHODS: We included in this nonrandomized open study patients with ACS older than 18 years with intact coronary arteries or confirmed at coronary angiography stenosis <50%. Genotypes of these patients were analyzed by 8 polymorphic variants of the hemostatic system genes which previously were found to be associated with the thrombophilia risk: F2 (20210 G>A) rs1799963, F5 (1691 G>A) rs6025, F7 (10976G>A) rs6046, F13 (163 G>T) rs5985, F1 (-455G>A) rs1800790, GP Ia - Ila (807C>t) rs1126643, GP Ilb-IIIa (1565 T>C) rs5918, PAI-I (-6755G>4G) rs1799889. Activities of protein C, Von Willebrand factor, plasminogen, and antithrombin III were also determined. RESULTS: Of 913 patients with ACS in 30 (3.3%) with mean age 54±11 years we detected NCA. Acute myocardial infarction (AMI) was diagnosed in 24 (80%), unstable angina - in 6 (20%) patients. Only in 1 patient we found no carriage of thrombosis associated genotypes. The frequency of occurrence of the heterozygous genotype of the factor V gene was 1 (3%). Heterozygous genotype of the factor XIII was registered significantly more often in patients with present atherosclerotic lesion compared with those with intact coronary arteries. Mean activity of protein C was 103% [90; 110], antithrombin III - 96% [88; 103], Von Willebrand factor - 137% [114; 162], plasminogen - 109% [102; 112]. At admission lowering of antithrombin III and protein C activities was detected in 4 cases (13%). In dynamics level of these parameters was restored. Elevation of Von Willebrand factor activity at admission was detected in 14 cases (14%) and remained elevated one year after the index event. There was no association between of fibrinogen level, protein C activity, rs1800790 and rs6025 gene polymorphisms, respectively. One-year mortality was 7% (n=2). For one year occurred 1 AIM recurrence (3%), heart failure developed in 15 patients (50%), 11 patients (37%) were repetitively hospitalized due to all causes. No association was revealed between activity of studied blood serum markers and 1 -year outcomes (death, re-AIM, rehospitalization). CONCLUSION: Among ACS patients 3.3% had NCA, what corresponded to the literature data. Carriage of at least 1 polymorphic variant of 8 thrombosis associated genes of the coagulation system was found in 97 % of patients with ACS and NCA. Distribution of these variants was like that in the European population and in patients with AIM at the background of stenosing atherosclerosis. Level of serum markers did not depend on distribution of polymorphic variants of the coagulation system genes, and presence of atherosclerotic coronary artery lesions. There was no association between hospital and long-term outcomes and distribution of polymorphic variants of thrombosis associated coagulation system genes, as well as levels of blood serum markers.


Assuntos
Síndrome Coronariana Aguda , Doença da Artéria Coronariana , Hemostáticos , Síndrome Coronariana Aguda/genética , Adulto , Idoso , Doença da Artéria Coronariana/genética , Hemostasia , Humanos , Pessoa de Meia-Idade , Polimorfismo Genético
20.
Rinsho Ketsueki ; 60(9): 1283-1291, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31597854

RESUMO

It is well known that platelets play a crucial role in hemostasis, but it has recently been revealed that platelets are also necessary for organ development. The platelet activation receptor CLEC-2 activates platelets by binding to the membrane protein, podoplanin, on the surface of lymphatic endothelial cells. This results in the release of TGF-ß family from activated platelets to facilitate blood/lymphatic vessel separation. TGF-ß also acts on lung mesothelial cells, which leads to their differentiation into alveolar duct myofibroblasts (adMYFs) and their migration into the inside of the lung. adMYFs generate elastin, which gives elasticity to the lung. Therefore, mice deficient in either CLEC-2 or podoplanin exhibit blood/lymphatic vessel misconnection and die just after birth due to respiratory failure. It had been previously surmised that biologically active substances from cells act on neighboring cells, leading to organ development, and the role of blood cells in organ development had not been elucidated. However, it has recently been demonstrated that blood platelets contain biological active substances in their granules, which are released when and where necessary by specific interactions between platelet receptors and their ligands. Now platelets are recognized as a "biological package" that actively facilitates organ development.


Assuntos
Plaquetas/citologia , Pulmão/embriologia , Animais , Células Endoteliais , Hemostasia , Camundongos
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