[The clotting tests and molecular markers in evaluating of coagulation alterations against the background of anti-thrombotic prevention by Dabigatran after large orthopedic operations].

The large orthopedic operations are associated with high risk of development of thrombosis of deep veins of lower extremities. Nowadays, new oral anticoagulants are widely applied for anti-thrombotic prevention. The coagulation alterations against the background of effect of Dabigatran, a direct inhibitor of thrombin were examined in 30 patients underwent endoprosthesis replacement of knee joint. The routine clotting indices, fibrinopeptid A, soluble fibrin-monomeric complexes, D-dimer. The samples of blood were selected before operation, after 30 minutes, and at 1st, 3d, 7th and 14th day after endoprosthesis replacement of knee joint. It is demonstrated that routine clotting tests and also detection of D-dimer and soluble fibrin-monomeric complexes provide no adequate evaluation of coagulation activity in patients underwent large orthopedic operation. The concentration of specific marker of fibrin formation of fibrinopeptid A continues to be increased no less than two weeks after endoprosthesis replacement of knee joint that testifies keeping hyper-coagulation and risk of thrombosis. The intake of Dabigatran etexilate in fixed dosage does not exclude development of thrombosis of deep veins of lower extremities that substantiates point of view concerning usefulness of individualization of anti-thrombotic prevention in case of application of new oral anti-coagulants.

Activities of clotting, fibrinolytic, and anticoagulant components of plasma hemostasis in patients with degenerative diseases of large joints.

Analysis of plasma hemostasis parameters was carried out in 110 patients with degenerative diseases of hip or knee joints hospitalized for initial endoprosthetics. Molecular markers of clotting and fibrinolysis and physiological anticoagulants were studied. Activities of all components of plasma hemostasis were normal in 29.4% patients. In 54.1% patients, high clotting activity was compensated for by adequate fibrinolysis activity. High thrombin formation was compensated for by high consumption of physiological anticoagulants in 10.1% patients. In 6.4% patients, high clotting activity was not paralleled by high fibrinolytic activity.

[Crystallization of biological fluids in a closet cell. Example of saliva]. / Kristallizatsiia biozhidkosti v zakrytoi iacheiki na primere sliuny.

The informative value of the method of crystallization of biological fluids in a closed cell for analysis of salivary pools from patients with myocardial infarction is assessed. The structural features of the saliva varied not only in health and disease, but depended on the disease severity as well. The method can be used for analysis of oral fluid in various diseases and for screenings.

[Dependence of haemostasis system response from initial blood coagulation activity under total joints replacement].

Effect of the initial state of the plasma hemostasis on the hemocoagulation changes after the total arthroplasty surgery was studied in 100 patients with osteoarthritis. Indicators of coagulation, fibrinolysis, and physiological anticoagulants were determined before and after completion of the surgery, at days 1, 3, 7, and 13-14 postoperatively. Increased coagulation activity befor surgery enhanced blood clotting within three days after the surgery. Enhanced consumption of physiological anticoagulants reduced the ability to recover their level a week after arthroplasty. The raised activity of the fibrinolysis inhibitor retained the effect during three postoperative days. Initial abnormalities in plasma hemostasis enhance blood coagulation dysfunction caused by surgical intervention on the large joints.