Dynamic changes and influencing factors of vitamin K levels in neonates / 中国新生儿科杂志

Objective:To study the incidences of vitamin K 1 and K 2 deficiency (VKD) in umbilical cord blood (UBC) of neonates and the dynamic changes and influencing factors of serum vitamin K 1 levels after preventive vitamin K 1 supplementation. Methods:From January 2021 to June 2022, neonates born in the Obstetrics Department of our hospital were prospectively enrolled and the levels of vitamin K 1 and K 2 in UBC and serum vitamin K 1 levels at 14 d and 28 d after vitamin K 1 supplementation were measured. The neonates were assigned into hospitalization group and healthy group and further assigned into early-preterm, late-preterm and full-term groups based on gestational age (GA). The incidences of VKD of different GA were studied. Dynamic changes of vitamin K 1 levels were calculated. Multivariate logistic regression was used to analyze the influencing factors of vitamin K 1 levels in hospitalization group at 28 d. Results:A total of 100 neonates were included. 80 neonates were hospitalized, including 25 early-preterm, 25 late-preterm and 30 full-term. 20 were healthy full-term neonates. No significant differences existed in the incidences of VKD of different GA ( P>0.05), however, the overall incidences were high (82.0% and 84.0%, respectively). After preventive vitamin K 1 supplementation, the levels of vitamin K 1 in full-term and preterm groups at 14 d were higher than at birth and 28 d. The levels of vitamin K 1 in hospitalized full-term neonates at 14 d and 28 d were higher than hospitalized preterm neonates. The levels of vitamin K 1 at 28 d in healthy group was significantly higher than hospitalization group ( P<0.05). Multivariate logistic regression analysis showed that maternal complications during pregnancy ( OR=5.889, 95% CI 1.621-21.399, P=0.007) and neonatal antibiotic use ( OR=5.615, 95% CI 1.833-17.221, P=0.003) were risk factors and formula feeding ( OR=0.389, 95% CI 0.193-0.786, P=0.008) was a protective factor for VKD. Conclusions:VKD is common in neonates. The serum vitamin K 1 level increases significantly after preventive vitamin K 1 supplementation. The vitamin K 1 levels of hospitalized full-term neonates at 14 d and 28 d are higher than hospitalized preterm neonates. The levels of vitamin K 1 at 28 d in hospitalized neonates are influenced by feeding methods, maternal complications during pregnancy and neonatal antibiotic use.

Treatment experience of a case of brodifacoum poisoning / 中国职业医学

OBJECTIVE: To analyze the experience of diagnosis and treatment of a case of brodifacoum poisoning. METHODS: The clinical data of a case of unexplained brodifacoum poisoning was retrospectively analyzed. RESULTS: The patient went to the doctor for unexplained bleeding. The bleeding symptoms included nasal o blood ozing, blood in saliva and skin ecchymosis. Blood anticoagulative rodenticide test showed positive with brodifacoum. The results of coagulative function tests showed that the indexes of partial prothrombin time, prothrombin time and fibrinogen were increased. The patient was diagnosed as brodifacoum poisoning based on the clinical symptoms and laboratory test results. The combined use of 40 mg/d of vitamin K_1 and frozen plasma improved the clotting time and quickly alleviated the bleeding symptoms of the patient. However, the patient′s bleeding symptoms recurred when vitamin K_1 was discontinued. The patient was hospitalized for 62 days and then discharged. With follow-up one month after discharge, the patient showed no bleeding symptoms, but brodifacoum could still be detected in the blood. CONCLUSION: The symptoms of brodifacoum poisoning may relapse and the treatment course is long. Vitamin K_1 could be used as the first-choice medicine for the treatment of brodifacoum poisoning, but its usage needs to be optimized.

Preparation and in vitro evaluation of vitamin K1-loaded erythrocyte drug delivery system / 国际药学研究杂志

Objective: To establish a vitamin K1(VK1)-delivery system with red blood cells as carrier. Methods: The VK1 self-emulsifying nano-emulsion, micelle and plasma solution were prepared to investigate the VK1 loading on red blood cells. The VK1- chitosan(CS)nanoparticles were prepared with different particle size by the 3 different preparation methods, and the effect of the particle size and charge property on the VK1-loading on red blood cells was investigated with the prepared VK1-CS nanoparticles. The encapsulation efficiency and drug loading were used as main indicators to investigate the appropriate drug loading method. Results: Due to the solubility of VK1 or the charge properties of nanoparticles, the drug loading and encapsulation efficiency of the red blood cell-encapsulated VK1 were quite low, and a large amount of drugs could not be loaded on the red blood cells. The ability of red blood cells to load VK1 was likely related to its Zeta potential. The VK1-CS nanoparticles prepared by the ion condensation method showed a good drug loading performance. Each milliliter of red blood cells could load 174.46 μg VK1 in the nanoparticles, and the loading rate was 85.11%. Conclusion: The VK1 loading by the red blood cells could be achieved by the electrostatic interaction between the positively charged chitosan nanoparticles and the negatively charged erythrocyte membrane.

Intoxicación con rodenticidas anticoagulantes: serie de casos y revisión de literatura / Intoxication with anticoagulant rodenticides: Case series and review of the literature

Introducción. Los superwarfarinicos (SWF) son una de las herramientas utilizadas por el ser humano para el control de roedores y a la vez son tóxicos para el hombre y pueden conducir a la muerte sin los debidos cuidados en su uso.Casos clinicos. Tres pacientes masculinos, que consultaron por sangrados (gingivorragia, epistaxis, hematuria, hemartrosis y hematomas cutaneos) asociados a alteraciones del coagulograma (Tiempo de protrombina (TP) y tiempo de tromboplastina parcial (KPTT) prolongados). Todos tuvieron exposición a superwarfarinicos. Nuestro servicio no dispone del análisis de SWF en suero. Se administró vitamina K1 en los tres pacientes y plasma fresco congelado (PFC) en uno solo (sangrado mayor: hematuria). El seguimiento se realizó mediante controles seriados de coagulograma y su evolución fue favorable. Discusión. En todos los casos, el diagnóstico de intoxicación por SWF fue clínico, basado en caracteristicas clínicas de pacientes y alteraciones en sus parámetros de coagulación, y debido a imposibilidad de derivación de análisis a otro laboratorio. Se realizo tratamiento especifico (vitamina K1 y PFC) segun recomendación de expertos, ya que no hay hasta la fecha, estudios clinicos que evaluen las diferentes opciones terapéuticas. Conclusión. La intoxicación por SWF aunque no es frecuente, debe sospecharse en casos de paciente con coagulopatia sin otras causas que puedan justificarlo. El manejo del cuadro tóxico es la reposición de vitamina k y de plasma fresco congelado, en casos donde se necesite una rápida corrección de la alteración hemostática, como los sangrados mayores. Es imprescindible la oportuna consulta con médicos hematólogos y/o la consulta con un centro regional de control de intoxicaciones para todas las exposiciones sospechosas por SWF.

Introduction. Superwarfarinics (SWF) are one of the tools used by humans for rodent control. They are toxic to humans and can lead to death without due care in its use. Clinical cases. Three male patients, who consulted due to bleeding (gingivorragia, epistaxis, hematuria, hamartrosis and skin hematomas) associated with coagulogram alterations (prolonged protombine time (PT) and partial thromboplastin time (KPTT)). All them exposure to superwarfarinics. SWF serum analysis was not available in our hospital. Vitamin K1 was administered in all three patients and fresh frozen plasma (PFC) in only one (major bleeding: hematuria). The followup was performed by serial coagulogram controls and the evolution was. Discussion. In all cases, the diagnosis of SWF intoxication was clinical, based on clinical characteristics of patients and alterations in their coagulation parameters, due to the impossibility of deriving the analysis of SWF in serum to another laboratory. Specific treatment was carried out (vitamin k and PFC) according to experts' recommendation, since there are no clinical studies to evaluate the different therapeutic options to date. Conclusion. SWF poisoning, although not frequent, should be suspected in patients with coagulopathy without other causes that may justify it. The management of toxic symptoms is the administration of vitamin K1 and fresh frozen plasma, in cases where a rapid correction of the haemostatic alteration is required, such as major bleedings. It is essential to consult with hematologists and / or consult a regional poison control center for all suspicious exposures by superwarfarins.

Three-dimensional structure of beads self-assembled by cyclodextrin using synchrotron radiation X-ray microcomputed tomography / 药学学报

Beads, a novel drug delivery system self-assembled by cyclodextrins (CDs) and oil, has potential applications in the solidification of oil drugs and improving the bioavailability of lipid-soluble drugs. However, very few researches were dedicated to the mechanism of beads formation. In this study, three-dimensional structures of beads were visualized and investigated using synchrotron radiation X-ray microcomputed tomography (SR-μCT). The structural changes of beads attributed by drying process were analyzed and confirmed via visualization results of SR-μCT. Productively, it was proposed that Pickering emulsion droplets obtained during beads formation process were spatially localized orderly. Moreover, the effects of loading lipid soluble drug, namely, vitamin K1, on the structural changes of beads were also analyzed. It is well known that the surface tension of oil phase could be changed by the addition of lipid soluble constituents. It was reasonable that the three-dimensional structure of beads might be altered during the drug loading of vitamin K1 into the beads. However, although the morphologies of beads were changed to some extent, the ordered Pickering emulsion droplets during the process of beads formation was successfully illustrated based on the SR-μCT results. Conclusively, according to the three-dimensional structural analysis of the beads, this study revealed the organized architecture for Pickering emulsion droplet assembly and beads formation in cyclodextrin semi-inclusion complex, which significantly complements the formation mechanism of beads, and provides a structural basis for the further study of beads.

Clinical characteristics and treatments of anti-coagulant rodenticide poisoning in children lacking of poisoning history / 中国小儿急救医学

Objective To summarize the clinical characteristics,diagnosis and treatments of 50 chil-dren with no history of anti-coagulation rodenticide poisoning.Methods Fifty children lacking of poisoning history were admitted to our hospital from Feb 2011 to Dec 2015,who were due to hemorrhage and finally di-agnosed as rodenticide poisoning.The clinical manifestation,characteristics of blood coagulation dysfunction, toxicology screening results and treatments of 50 cases were retrospectively analyzed.Results All 50 cases were from rural area,and denied the history of taking rodenticide by mistake.The time from the onset to ad-mission to the hospital was from 1 d to 120 d,with an average of 11.66 d.Major clinical manifestations in-cluded:34 cases(68%)of skin ecchymosis,26 cases(52%)of epistaxis,10 cases(20%)of bleeding gums and 4 cases(8%)of hematoma at the injection site,with PT 20 to over 200 s and APTT 31 to over 200 s (maximal detection value).The children were diagnosed as rodenticide poisoning when one of brodifacoum, bromadiolone,and diphacinone-sodium or combination of brodifacoum and bromadiolone were detected from their blood specimens,with an concentration of 5 to 3 270 μg/L.The diagnosed children were intravenous dripped with specific antagonist vitamin K1 and the critically ill children were added fresh frozen plasma.All children recovered from hemorrhage within 24 hours after treatment.The level of PT,APTT was close to nor-mal after 3 to 7 days of treatment,and the using of vitamin K1 was accumulated about 30 to 70 mg.The chil-dren were given maintenance treatment of vitamin K1 for three months after discharge until the condition was stable.Conclusion Commonly used rodenticide has the characteristics of fat soluble, easy to accumulate, long incubation period,and long treatment period and so on.Children with no bleeding performance have the clinical tendency of acute bleeding,prolonged PT and APTT should be considered the possibility of rodenti-cide poisoning.Blood or urine samples should be screened for toxicology as soon as possible,and meanwhile children should be given antagonist treatment with special antidote vitamin K1 until the coagulation function is stable in normal range to avoid recurrence of the illness.

Quality control and physico-chemical properties of vitamin K1 self-nanoemulsifying drug delivery systems / 国际药学研究杂志

Objective To establish assay methods for the determination of dissolution,content and related substances of vita-min K1 self-nanoemulsifying drug delivery system(VK1-SNEDDS),and investigate the physico-chemical properties of the preparation. Methods The UV method was established to determine the dissolution of VK1-SNEDDS. The content and related substances were de-termined by HPLC. The appearance,self-emulsification time,micro-morphology,droplet size and zeta potential were also investigat-ed. Results The linearity range of established UV and HPLC methods was 0.85-20.4 and 2.16-216μg/ml,respectively,and all the recovery,precision,specificity and sensitivity met requirements. VK1-SNEDDS could disperse quickly after dilution. The transmission electron microscope(TEM)image of the optimized liquid SNEDDS showed that most of the emulsion droplets were of uniform size with no signs of coalescence. Droplet size of optimal formulation was revealed as 47.74 nm with polydispersibility index(PDI)of 0.248,and zeta potential was found to be-20.53 mV. Conclusion VK1-SNEDDS could form homogeneous and stable nanoemulsion when dilut-ed with aqueous phase and increase the dissolution of lipophilic drug. The methods are reliable,accurate and suitable for quality con-trol of VK1-SNEDDS.

Efficacy of vitamin K1 in the adjuvant treatment of pertussis syndrome / 中国基层医药

Objective To investigate the effects of vitamin K1 in the adjuvant treatment of spasmodic cough in pertussis syndrome children,and its impacts on length of hospital stay.Methods 87 pertussis syndrome children were randomly divided into two groups,among which 41 cases in the control group were treated with the therapies such as anti -infection,respiratory support,antispasmodic,expectorant et al,while 46 cases in the treatment group were treated additionally with vitamin K1 on the basis of the control group.Then compared the duration and hospital stay of the two groups with spasmodic cough.Results The disappeared time of spasmodic cough in the treatment group was (7.22 ±1.33)d and hospital stay was (9.52 ±1.84)d,which in the control group were (15.51 ±2.73)d,(18.71 ± 3.30)d respectively,and there were statistically significant differences(t =-18.310,-16.269,all P <0.01).In the treatment group,the total effective rate was 93.5%,there were 18 cases with markedly effective,25 cases with effective and 3 cases with ineffective.Correspondingly,there were 7 cases markedly effective,23 cases effective, 11 cases ineffective,and total efficiency rate was only 73.1% in the control group,the difference was statistically significant(χ2 =4.285,P <0.05 ).Conclusion Vitamin K1 to alleviate spasmodic cough in children has a significant effect,which can reduce the duration of the cough time and hospital stay in pertussis syndrome children, and also can improve the clinical effect.

Effects of phylloquinone supplementation on lipid profile in women with rheumatoid arthritis: a double blind placebo controlled study

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin K1 in lipid profile modification remains still controversial. This study showed that vitamin K1 has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

Effects of phylloquinone supplementation on lipid profile in women with rheumatoid arthritis: a double blind placebo controlled study

BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) is associated with an excess mortality from cardiovascular disease which is likely attributed to an atherogenic lipid profile. Among nutritional factors vitamin K has been recently focused as a pivotal nutrient in improvement of lipid related markers. Thus, this study was designed to determine the effects of vitamin K on lipid profile in this disease. SUBJECTS/METHODS: Fifty eight patients with definitive RA were participated in the present double blind placebo controlled study. They were randomly allocated into two groups to receive vitamin K1 as phylloquinone [10 mg/day] (n = 30) or placebo pills (n = 28), for eight weeks. In order to control the effects of probable confounders dietary intakes, anthropometric measurements including weight and height, clinical status using disease activity score-28 (DAS-28), physical activity and anxiety status were evaluated at baseline. Moreover, serum levels of lipid related markers including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) were measured at baseline and at the end of intervention. RESULTS: There were no significant differences between the two groups regarding any of the baseline characteristics. After adjusting for some relevant confounders, in comparison between two groups, we observed no significant changes in lipid related markers at the end of intervention. Also, there was no significant difference between before and after intervention values within groups (P > 0.05). CONCLUSIONS: Function of vitamin K1 in lipid profile modification remains still controversial. This study showed that vitamin K1 has no effect on lipid profile in women with rheumatoid arthritis. Further studies with a longer follow-up are required to determine the effects of vitamin K on atherogenic lipid profile.

Effects of vitamin k1, fresh frozen plasma and cryoprecipitate on coagulation index of newborns with different gestational ages / 实用医学杂志

Objective To explore the effect of Vitamin K1(Vit K1), fresh frozen plasma (plasma) andcryoprecipitate on prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen original(Fbg), thrombin time (TT) of newborns with different gestational ages. Methods The serum of 1,134 newbornsfrom The Third Affiliated Hospital of Guangzhou Medical University was collected from February 2009 to September2012. All newborns had been divided into four groups (according to the gestational age of 28-31+6 weeks, 32-33+6weeks, 34-36+6 weeks and gestational age≥37 weeks).The effect of various interventions (Vit K1, Vit K1+plasmaand Vit K1+cryoprecipitate) on PT, APTT, Fbg, and TT had been recorded. Results (1)The PT and APTT ofeach group with the interventions of Vit k1 were significantly improved (P < 0.05). (2)The PT, APTT, Fbg and TTof each group with the interventions of Vit k1 combined with plasma were significantly improved (P < 0.05). (3)ThePT, APTT and Fbg of each group with the interventions of Vit k1 combined with cryoprecipitate were significantlyimproved (P < 0.05). (4)With Vit k1 combined with plasma, PT and APTT were mostly improved and Fbg wasimproved mostly with Vit k1 combined with cryoprecipitate. Conclusion Vitamin K1, fresh frozen plasma andcryoprecipitate can effectively improvedin the coagulation index of newborns with different gestational ages.

Replacing solubilizer with lipid microspheres eliminates the severe adverse reaction of vitamin K1 injection / 中国药学杂志

OBJECTIVE: To investigate whether substituting the solubilizer with lipid microspheres in vitamin K1 injection can eliminate the anaphylactoid reaction.

Teores de vitamina K em hortaliças consumidas na cidade de São Paulo / Levels of vitamin K in vegetables consumed in the city of São Paulo

Estudos sobre a vitamina K têm evidenciado seu papel na manutenção da saúde óssea e vascular. A atuação desta vitamina em tecidos extra-hepáticos não é considerada na recomendação dietética da DRI de 2001, sendo reconhecidas necessidades maiores para função óssea em pessoas acima dos 60 anos e em indivíduos que fazem uso de medicamentos antivitamina K. Visando colaborar com pesquisas futuras, onde o conhecimento do teor de vitamina K1 é relevante, além de contribuir com dados para Tabela Brasileira de Composição de Alimentos - TBCA-USP, o presente trabalho foi conduzido para determinação do teor de filoquinona (vitamina K1) de hortaliças consumidas na cidade de São Paulo. As hortaliças analisadas foram escolhidas após a conclusão de um inquérito alimentar realizado, com adultos e idosos, num projeto de pesquisa desenvolvido junto ao Departamento de Alimentos e Nutrição Experimental da FCF/USP visando a análise da ingestão diária de vitamina K. Desta forma, foram analisadas as hortaliças mais consumidas por esses grupos, submetidas ou não ao processo de cocção. Estas amostras foram adquiridas diretamente na CEAGESP - Companhia de Entrepostos e Armazéns Gerais de São Paulo. As metodologias empregadas na determinação da filoquinona (vitamina K1) foram extração e purificação pelo método líquido-líquido utilizando solventes orgânicos e quantificação através da Cromatografia Líquida de Alta Eficiência (CLAE). Os resultados mostraram que as amostras de hortaliças de colorações verdes mais escuras apresentaram os maiores teores da vitamina como: salsa 491,05 µg/100g; espinafre 375,01 µg/100g, quando comparados com as amostras de colorações verdes mais claras as quais como é o caso da alface americana 113,42 µg/100g e a couve-flor 32,55 µg/100g. A maioria das hortaliças analisadas apresentaram variações entre as diferentes épocas do ano e quando comparadas com dados da literatura

Studies on vitamin K have shown its role in maintaining bone and vascular health. The role of this vitamin in extrahepatic tissues is not considered in the dietary recommendation of DRI 2001. Increased need for vitamin K intake is recognized for the bone function in people over age 60 and individuals who use anti-vitamin K drugs. Aiming at supporting future research, where knowledge of vitamin K1 is relevant, and contribute data to the Brazilian Table of Food Composition - TBCA-USP, this study was conducted to determine the level of phylloquinone (vitamin K1) of vegetables consumed in the city of São Paulo. The vegetables studied were chosen after completion of a nutrition survey carried out with adults and elderly people, a research project developed by the Department of Food and Experimental Nutrition FCF / USP aimed at analyzing the daily intake of vitamin K. Therefore, we analyzed the most consumed vegetables by these groups submitted or not to the cooking process. These samples were acquired directly at CEAGESP - General Warehouses Company of São Paulo. The methodologies employed in the determination of phylloquinone (vitamin K1) were extraction and purification method using liquid-liquid organic solvents followed by High Performance Liquid Chromatography (HPLC). The results showed that the samples of darker green vegetables showed the highest levels of vitamin such as parsley (491.05 µg/100g) and spinach (375.01 µg/100g), when compared with samples of lighter coloration (e.g. 113.42 µg/100g lettuce, and 32.55 µg/100g cauliflower). Most vegetables analyzed showed variation in results when compared to the different seasons and the literature data

A case of suicidal rat poisoning masquerading as homicide.

This is a case report of bromadiolone poisoning, which was mistaken initially as a case of assault and homicide by the relatives and police. Bromadiolone acts by inhibiting vitamin K synthesis and produces multiple areas of bleeding that can bear a superficial resemblance to contusions. The history however, later revealed that the deceased had consumed a rat poison whose main constituent was bromadiolone. The clinical diagnosis of disseminated intravascular coagulation was supported by the his-topathology findings, and the toxicological analysis confirmed the presence of bromadiolone. The antidote to this compound is vitamin K1 and in severe cases, whole blood or plasma also should be used. Once the patient has stabilized, and in less severe cases, vitamin K1 can be given orally.

Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1, and this malady presents as an erythematous eczematoid patch or pseudoscleroderma. At first, liver disease was thought to be related to vitamin K1 dermatitis. However, it is no longer considered as being related to liver disease due to the increasing case reports of patients with vitamin K1 dermatitis and who are without liver disease. Type IV hypersensitivity reaction was suspected to be the cause of this reaction. This disease can be easily ignored because of its low incidence. We hereby report on a case of vitamin K1 dermatitis that was confirmed by a skin test.

Clinical analysis of 45 patients with acquired deficiencies of vitamin K-dependent coagulation factors / 中国综合临床

Objective To explore the acquired deficiencies of vitamin K-dependent coagulation factors in etiology, clinical characteristics and treatment. Methods Retrospective analysis was performed on the data of etiology, clinical manifestations of 45 patients with acquired deficiencies of vitamin K-dependent coagulation factor. All patients were treated with Vitamin K1 10 -40 mg/d, i. v. , for three months. Some patients with severe blooding were additionally treated with fresh freezing plasma or prothromibin complex. Prothrombin time(PT) and activated partial thromboplastic time(APTT) were measured using Stago automatic blood coagulation analyzer before and after treatment. Ⅱ , Ⅶ, Ⅸ and Ⅹ were measured in some patients. Results Among the 45 cases, no certain cause was found in 19 cases (42.2%), anticoagulant rodenticides poison was a common cause ( 11 cases,42.3% ). The main presentations was hemorrhage, the most common bleeding sites were mucosa (77.8%) (35/45)and hematuria (46.7%) ( 21/45 ). After vitamin K1 treatment, PT and APTT had shortened remarkably from ( 110.35 ± 35.36 ) s,(98.91 ±48.98)s to (13.48 ±2. 17)s,(33.25 ±6.95)s,respectively(t=19.10 and 6.19,Ps ＜0.01)and the activities of factor Ⅱ、Ⅶ、Ⅸ、Ⅹ had rapidly increased from ( 17.48 ± 10.93 ) %, ( 10.23 ± 5.68 )%, ( 11.98 ±4.69)%,(12.93±7.48)% to (70. 12 ±21.31)%,(92.76 ±29. 15)%,(88.64 ±40. 21)%,(63.97 ±20.11)%(t=12.13,14.43,13.27and9. 74,respectively,Ps＜0. 01).Conclusions The histories of patients with acquired deficiencies of vitamin K-dependent coagulation factors are usually hiding, therefore it is easily misdiagnosed. It is worth of detecting PT and APTT in diagnosis and monitoring. Using vitamin K1 10 -40 mg/d is effective and safety.

A Case of Vitamin K1 Dermatitis due to Intralesional Injection for Cosmetic Purpose / 대한피부과학회지

Vitamin K is a lipid-soluble vitamin used in the treatment of hypoprothrombinemia found in diseases of the liver, biliary tract and small intestine. Vitamin K1 (Phytonadione) is the natural form of vitamin K. Recently, a cream containing vitamin K1 has been marketed for topical use in the treatment of periorbital hyperpigmentation, telangiectasia and rosacea. Vitamin K1 dermatitis is a cutaneous adverse reaction to vitamin K1 and can cause acute pruritic, erythematous, eczematoid, indulated plaques or slowly-appearing sclerodermatous plaques. We present a case of dermatitis caused by a vitamin K1 intralesional injection for treatment of facial telangiectasia and flushing.

A Case of Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).

A Case of Vitamin K1 Dermatitis / 대한피부과학회지

Vitamin K1 is a naturally-occurring vitamin used to treat certain coagulation disorders, and cutaneous adverse reaction to vitamin K1 are infrequently reported. The cutaneous adverse reaction caused by vitamin K1 is called vitamin K1 dermatitis, and includes erythematous plaques, peudoscleroderma, contact dermatitis on epicutaneously exposed skin, and localized urticarial lesions. Vitamin K1 dermatitis can easily be overlooked because of it's low incidence and various morphology, therefore, awareness of past history is important. Most cases of vitamin K1 dermatitis previously reported have been associated with liver diseases, primarily alcoholic liver cirrhosis and viral hepatitis. However vitamin K1 dermatitis can be seen, not only in patients with liver function disturbances, but also in patients without liver disease. We report a case of vitamin K1 dermatitis in a woman who had no liver dysfunction (confirmed by skin test).

Study on feasible prophylactic proposal for the periventricular-intraventricular hemorrhage in preterm infants / 中华围产医学杂志

Objective To study the feasible prophylactic proposal for the periventricular-intraventricular hemorrhage(PIVH)in preterm infants with the aim to reduce the mortality and improve the prognosis.Methods From January 2004 to June 2005,pregnant women at high risk for preterm delivery and with gestational age of less than 35 weeks and their infants were enrolled and divided into five groups randomly.Pregnant women received antenatal intramuscular or intravenously injection of vitamin K_1 10 mg per day for 2 to 7 days were Group A.Group B received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 1 day.Group C received antenatal intramuscular or intravenously injection of dexamethasone 10 mg per day for 2 days.Group D received dexamethasone 10 mg per day for 1 or 2 days and vitamin K_1 10 mg per day for 2 to 7 days.Infants in the phenobarbital group received intravenous injection of phenobarbital within 3 hours after birth for 3 to 5 days.Infants in the control group received neither phenobarbital after birth nor dexamethasone or vitamin K_1 injection antenatally.Results PIVH was diagnosed in 17 of 40(42.5%)in Group A,34 of 63(54.0%)in Group B,36 of 70(51.4%)in Group C,14 of 44(31.8%)in Group D,they all higher than control group(?2=15.10,P=0.004).More infants in the control group had severe PIVH(Grade Ⅲ and Ⅳ)than other groups(?2=9.527,P=0.049).The incidence of PIVH and severe PIVH in Group B and Group C were no significant difference.Furthermore,the incidence of PIVH was no difference in phenobarbital group(60.0%)and control group(65.2%)(?2=0.361,P=0.548).But the incidence of severe PIVH in phenobarbital group(5.0%)was less than control group(18.4%)(?2=4.04,P=0.044).Conclusions The combined antenatal administration of dexamethasone and vitamin K_1 can reduce the incidence of PIVH in preterm infants.Postnatal administration of phenobarbital can not decrease the incidence of PIVH,but decrease the frequency of severe PIVH.