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1.
Semina cienc. biol. saude ; 43(1): 101-118, jan./jun. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1354575

ABSTRACT

Achyrocline satureioides is popularly known for its richness in phenolic compounds and medicinal properties (anti-inflammatory, analgesic, and hepatoprotective). The present study aimed at broadening the knowledge about the pharmacological potential exerted by the aqueous and ethanolic extracts of A. satureioides. These extracts were characterized by HPLC and tested for their modulatory action on phospholipases A2 and proteases of snake venoms. In addition, they were tested on the activities of digestive enzymes. Snake venoms were used as tools since they have enzymes with high functional and structural homology to human enzymes. The results demonstrate that the extracts of A. satureioides act as enzymatic inhibitors or potentiators, interfering in processes related to the hemostasis, such as coagulation and thrombus dissolution. In addition, the anti-genotoxic activity and inhibitions exerted on digestive enzymes suggests their potential use in the prevention and/or treatment of several pathologies. New studies could provide information on how the compounds present in the extracts and the different enzymes interact.


A Achyrocline satureioides é popularmente conhecida por sua riqueza em compostos fenólicos e por suas propriedades medicinais (anti-inflamatória, analgésica e hepatoprotetora). No presente estudo, com o objetivo de ampliar o conhecimento sobre o potencial farmacológico exercido por esses extratos, os extratos aquoso e etanólico de A. satureioides foram caracterizados por HPLC e testados quanto à sua ação modulatória sobre as fosfolipases A2 e proteases de peçonhas de serpentes. Além disso, também foram testados em atividades de enzimas digestivas. As peçonhas de serpentes foram usadas como ferramentas por apresentarem enzimas com alta homologia funcional e estrutural às humanas. Os resultados demonstram que os extratos de A. satureioides atuam como inibidores ou potencializadores enzimáticos, interferindo em processos relacionados à hemostasia, como coagulação e dissolução do trombo. Além do mais, destacam seu potencial antigenotóxico e as inibições exercidas sobre as enzimas digestivas direcionando seu potencial de uso na prevenção e/ou tratamento de diversas patologias. Novos estudos poderão fornecer informações sobre os mecanismos de interação entre os compostos presentes nos extratos e as diferentes enzimas.


Subject(s)
Humans , Animals , Snakes , Blood Coagulation , Achyrocline , Digestion , Enzymes , Dissolution , Phospholipases A2 , Hemostasis , Analgesics , Inflammation
3.
Ann. Health Res. (Onabanjo Univ. Teach. Hosp.) ; 8(1): 40-48, 2022. figures, tables
Article in English | AIM, AIM | ID: biblio-1362986

ABSTRACT

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others. Objective: To determine changes in haemorheological and clotting profile in post-menopausal women. Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods. Results: The mean age (p=0.01), platelet count (p= 0.013), neutrophil (p= 0.03), neutrophil to lymphocyte ratio (p= 0.045) and platelet to lymphocyte ratio (p=0.044) in postmenopausal women were significantly higher while lymphocyte count (p= 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p= 0.001), plasma viscosity (p= 0.03), relative blood viscosity (p= 0.03), whole blood viscosity (p= 0.03) and PTTK(p= 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects. Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.


Subject(s)
Humans , Female , Blood Coagulation , Blood Viscosity , Menopause , Postmenopause
4.
Rev. colomb. anestesiol ; 49(3): e601, July-Sept. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1280184

ABSTRACT

Abstract The new coronavirus 2019-nCov or SARS-Cov-2 is responsible for the most important pandemic in the 21st century: the coronavirus disease (COVID-19). The 2019-nCov infection elicits a hyper-coagulable state, conditioning a worse outcome in these patients. The pathophysiology of the exaggerated coagulation activation in these patients is still unknown, and probably involves several mechanisms, different from those involved in sepsis-associated coagulopathy. This article discusses the case of a patient with no remarkable medical history, who after 7 days of fever, diarrhea and epigastric pain was diagnosed with COVID-19 bilateral pneumonia, further aggravated by severe Acute Respiratory Distress Syndrome. In this context, the patient experienced a massive acute pulmonary thromboembolism accompanied by an acute thrombus in the heart's right ventricle, leading to hemodynamic instability. For the first time in our center in these patients, systemic fibrinolysis was successfully performed, with resolution of the intracavitary thrombus and the acute hemodynamic shock.


Resumen El nuevo coronavirus 2019-nCov o SARS-Cov-2 es responsable de la pandemia más importante del siglo XXI: la enfermedad del coronavirus (COVID-19). La infección por 2019-nCov produce un estado de hipercoagulabilidad, que promueve peores desenlaces en estos pacientes. La fisiopatología de la exagerada activación de la coagulación en estos pacientes aún se desconoce y posiblemente involucre varios mecanismos, diferentes a los participan en la coagulopatía asociada a sepsis. El presente artículo presenta el caso de un paciente sin antecedentes médicos y quien luego de 7 días de fiebre, diarrea y dolor epigástrico, fue diagnosticado con neumonía bilateral por COVID-19, agravada por la presencia de Síndrome de Dificultad Respiratoria Aguda. En este contexto, el paciente desarrolla un tromboembolismo pulmonar agudo masivo, acompañado de un trombo agudo en el ventrículo derecho, produciéndole inestabilidad hemodinámica. Por primera vez en nuestro centro, se realizó exitosamente una fibrinólisis sistémica, con resolución del trombo intracavitario y del shock hemodinámico agudo.


Subject(s)
Humans , Male , Adult , Pulmonary Embolism , Thrombosis , Blood Coagulation , Pandemics , Fibrinolysis , COVID-19 , Respiratory Distress Syndrome, Newborn , Coronavirus , SARS-CoV-2 , Heart Ventricles , Hemodynamics , Infections
5.
Rev. colomb. cardiol ; 28(4): 374-377, jul.-ago. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1351935

ABSTRACT

Resumen La coagulación intravascular diseminada es un proceso sistémico caracterizado por la activación generalizada de la coagulación, que tiene el potencial de causar trombosis vascular, hemorragia y falla orgánica. En raras ocasiones, las anomalías vasculares, como el aneurisma aórtico abdominal, pueden desencadenar coagulación intravascular diseminada crónica. Los aneurismas aórticos grandes, su disección y su expansión son factores de riesgo. En estos casos predominan los síntomas subclínicos y la coagulopatía solo se identifica mediante pruebas de laboratorio. Existe evidencia limitada basada en la experiencia de series de casos de coagulación intravascular diseminada crónica como complicación en pacientes con aneurisma aórtico abdominal. Además, la duración y la respuesta terapéutica a la heparina no se conocen bien, principalmente en los pacientes con manejo conservador. Se considera un desafío diagnóstico y terapéutico debido a la baja frecuencia de presentación. A continuación, se describen las características clínicas y paraclínicas, así como el tratamiento, de un paciente con aneurisma aórtico abdominal asociado con coagulación intravascular diseminada crónica.


Abstract Disseminated intravascular coagulation is a systemic process characterized by the widespread activation of coagulation with the potential for causing vascular thrombosis, hemorrhage and organ failure. Rarely, vascular anomalies like abdominal aortic aneurysm can trigger chronic disseminated intravascular coagulation. Large aortic aneurysms, dissection and expansion are risk factors. In these cases, subclinical symptoms predominate and coagulopathy is only identified by laboratory tests. Nowadays there is limited evidence based on experience from case series of chronic disseminated intravascular coagulation as complication in patients with abdominal aortic aneurysm. Furthermore, duration and therapeutic response with heparin therapy are not well known, mainly in those patients with conservative management. It is considered a diagnostic and therapeutic challenge due to the low presentation frequency. The clinical characteristics, laboratory and treatment of a patient with abdominal aortic aneurysm associated with chronic disseminated intravascular coagulation are described below.


Subject(s)
Humans , Aortic Aneurysm, Abdominal , Disseminated Intravascular Coagulation , Blood Coagulation , Risk Factors , Conservative Treatment
6.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1230, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251721

ABSTRACT

Introducción: Las plaquetas tienen una función clave en la hemostasia primaria a través de cuatro mecanismos fundamentales: adhesión, agregación, secreción y actividad procoagulante, todos controlados genéticamente por más de 50 genes asociados que han sido identificados. Las manifestaciones clínicas en las alteraciones hereditarias de las plaquetas suelen ser variables; aunque estas alteraciones de la coagulación suelen presentarse con una trombocitopenia notoria, también pueden exhibir trombocitopatías, en las cuales la capacidad hemostática de las plaquetas resulta afectada sin variar su número. Por tanto, existen gran variedad de manifestaciones fenotípicas y mutaciones en relación con la función plaquetaria, algunas de las cuales se explicarán más adelante. Objetivo: Realizar revisión práctica sobre mutaciones plaquetarias hereditarias de baja incidencia y destacar la importancia de su conocimiento, correcto diagnóstico, y tratamiento precoz. Métodos: Se realizó revisión literaria en inglés y españolen MEDLINE, EMBASE, Lilacs y ScienceDirect desde mayo 2019 hasta abril 2020, con el uso de combinación de palabras clave y términos MeSH relacionados con trombastenia, genética médica, hemostasis, agregación plaquetaria, trombopoyesis. Se efectuó análisis y resumen de la bibliografía revisada. Conclusión: Entre las alteraciones hereditarias de las plaquetas se pueden encontrar defectos en todos los mecanismos en que participan; sin embargo, la confirmación diagnóstica sigue siendo complicada por el tiempo y el costo que representa lo que ocasiona diagnósticos inadecuados que impactan en el manejo clínico y la evolución(AU)


Introduction: Platelets have a key role in primary hemostasis through four main mechanisms: adhesion, aggregation, secretion and procoagulant activity, all of these controlled by over 50 associated genes that have been identified. Clinical signs of hereditary platelets alterations are usually variable; even though these disorders of hemostasis generally course with a notorious thrombocytopenia, they also might have thrombocytopathies, in which the hemostatic capacity of platelets is affected without altering its number. According to this, there's a great variety of phenotypic manifestations and mutations that affect platelet function, some of these will be explained later on. Objective: To make a practical review of hereditary platelets mutations that have low incidence in population and to highlight the importance of knowing about them, how to diagnose them and early treatment. Methods: A review of literature in both Spanish and English, was done based on MEDLINE, EMBASE, Lilacs and ScienceDirect, during May 2019 and April 2020 using key words and MeSH terms such as thrombasthenia, medical genetics, hemostasis, platelets aggregation, thromopoiesis. Then, an analysis and summary of the reviewed bibliography was carried out. Conclusion: Among the hereditary alterations of platelets, many defects can be found in every mechanism involved; however, diagnostic confirmation is still complicated due to time and cost, causing inaccurate diagnoses that impact on clinic management and evolution(AU)


Subject(s)
Humans , Blood Coagulation , Blood Platelet Disorders/epidemiology , Platelet Aggregation/immunology , Early Diagnosis , Genetics, Medical , Hemostasis/genetics , Blood Platelet Disorders/prevention & control
7.
REVISA (Online) ; 10(1): 73-82, 2021.
Article in Portuguese | LILACS | ID: biblio-1177263

ABSTRACT

Objetivo: Caracterizar o perfil de hemofílicos vinculados a uma associação de pacientes em Brasília - DF, Brasil. Método: Pesquisa transversal com amostragem por conveniência, realizada com 49 hemofílicos adultos, do sexo masculino, vinculados à Associação dos Voluntários, Pesquisadores e Portadores de Coagulopatias (AJUDE-C). O estudo foi aprovado pelo Comitê de Ética em Pesquisas com Seres Humanos. Através de um formulário foi coletado informações sociodemográficas e clínicas. A normalidade dos dados foi avaliada através do teste de Shapiro-Wilk. Resultados: Avaliaram-se 49 hemofílicos adultos com média de idade 37 ±8,4 anos, estando 43% na faixa etária de 30-39 anos. Predominou a raça/cor parda (49%), estado civil solteiro (61%), em atividade laboral (57%) e 53% residiam a menos de 30 Km do local de tratamento. Clinicamente, predominou a hemofilia A (79,6%), doença grave (77,6%) e o uso de profilaxia secundária (75,5%). Conclusão: Maior parte da amostra exerce atividade laboral. Esse fato pode ser explicado pela administração da profilaxia secundária e proximidade entre a residência/local de tratamento, mantendo os fatores de coagulação em níveis seguros, e dando capacidade de rápido atendimento em casos emergenciais, gerando maior autonomia nessa população


Objective: To characterize the hemophiliacs profile linked to a patients association in Brasília - DF, Brazil. Method: Cross-cut survey with convenience sampling, carried out with 49 male hemophiliacs adults, linked to the Association of Volunteers, Researchers and People with Coagulopathies (AJUDEC). The study was approved by the Ethics Committee in Research with Human Beings.The Sociodemographic and clinical information was collected through a form. The normality of the data was evaluated using the Shapiro-Wilk test. Results: Were evaluated 49 adult male hemophiliacs with an avarage 37 ± 8.4 years. 43% were in the 30-39 age range. The brown race predominated (49%), single marital status (61%), in work activity (57%) and 53% lived less than 30 km from the treatment place. Clinical prevalence hemophilia A (79.6%), severe disease (77.6%) and the use of secondary prophylaxis (75.5%). Conclusion: Most of the sample is in work activity. This fact can be explained by the administration of secondary prophylaxis and proximity between their residence / treatment place. This keeps the clotting factors at safe levels, and provids quick assistance to emergencies cases, generating greater autonomy in this population.


Objetivo: Caracterizar el perfil de hemofílicos vinculados a una asociación de pacientes en Brasilia - DF, Brasil. Método: Encuesta transversal con muestra de conveniencia, realizada con 49 hemofílicos adultos, vinculados a la Asociación de Voluntarios, Investigadores y Personas con Coagulopatías (AJUDE-C). El estudio fue aprobado por el Comité de Ética y Investigación en Seres Humanos. La información sociodemográfica y clínica se recogió por medio de un formulario. La normalidad de los datos se evaluó mediante la prueba de Shapiro-Wilk. Resultados: se evaluaron 49 hemofílicos adultos con una edad media de 37 ± 8,4 años, 43% estaban en el grupo de edad 30 a 39 años. Predominó la raza marrón (49%), estado civil soltero (61%), en la actividad laboral (57%) y el 53% vivía a menos de 30 km del sitio de tratamiento. Clínicamente predominaron: hemofilia A (79,6%), enfermedad grave (77,6%) y el uso de profilaxis secundaria (75,5%). Conclusión: La mayor parte de la muestra tiene actividad laboral. Este hecho puede explicarse por la administración de profilaxis secundaria y la proximidad entre el lugar de residencia / tratamiento, manteniendo los factores de coagulación en niveles seguros y promoviendo la capacidad de atender rápidamente los casos de emergencia, generando una mayor autonomía en esta población


Subject(s)
Blood Coagulation , Disease Prevention , Hemophilia A
8.
Rev. Soc. Bras. Med. Trop ; 54: e00912021, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250836

ABSTRACT

Abstract Introduction: The efficacy of 20-minute whole blood clotting (WBCT20) and the Lee-White clotting time (LWCT) tests in diagnosing coagulation alterations from snakebites were compared. Methods: We evaluated 89 snakebite cases treated at the Hospital Regional do Juruá em Cruzeiro do Sul, Acre, Brazil. Results: WBCT20 results were normal in 33.7% and unclottable in 66.3% of cases, while LWCT results were normal in 23.6% and altered (prolonged or unclottable) in 76.4% of cases, with no significant differences. Conclusions: The WBCT20 is important for rapidly diagnosing coagulation alterations from snakebites. Furthermore, it is efficient, inexpensive, and can be deployed in isolated hospitals.


Subject(s)
Humans , Snake Bites/diagnosis , Blood Coagulation , Brazil , Hospitals
9.
Rev. latinoam. enferm. (Online) ; 29: e3415, 2021. tab
Article in English | LILACS, BDENF | ID: biblio-1280459

ABSTRACT

Abstract Objective: to evaluate the complications of percutaneous renal biopsy based on outcomes and clinical indicators of the Nursing Outcomes Classification. Method: a prospective longitudinal study. The sample consisted of 13 patients submitted to percutaneous renal biopsy, with 65 evaluations. The patients were evaluated in five moments in the 24 hours after the procedure, using an instrument developed by the researchers based on five outcomes (Blood coagulation, Circulation status, Blood loss severity, Pain level, Comfort status: Physical) and 11 indicators. The Generalized Estimation Equation Test was used to compare the scores of the indicators. The project was approved by the institutional ethics committee. Results: in the 65 evaluations, a statistically significant difference was identified in the reduction of the scores of the following nursing outcomes: Blood coagulation, "hematuria" indicator; Circulation status, in the "systolic blood pressure and diastolic blood pressure" indicators and Comfort status: physical, in the "physical well-being" indicator. Conclusion: the evaluated patients did not show major complications. The clinical indicators signaled changes in circulation status, with reduced blood pressure, as well as in blood clotting observed by hematuria, but without hemodynamic instability. The comfort status was affected by the rest time after the procedure.


Objetivo: evaluar las complicaciones de la biopsia renal percutánea con base en los resultados e indicadores clínicos de la Nursing Outcomes Classification. Método: estudio longitudinal prospectivo. La muestra fue de 13 pacientes a los que se les realizó biopsia renal percutánea, con 65 evaluaciones. Los pacientes fueron evaluados en cinco momentos en las 24 horas posteriores al procedimiento, utilizando un instrumento desarrollado por los investigadores con base en cinco resultados (Coagulación sanguínea, Estado circulatorio, Severidad de la pérdida de sangre, Nivel de dolor, Estado de comodidad: física) y 11 indicadores. Se utilizó la Prueba de Ecuación de Estimación Generalizada para comparar los puntajes de los indicadores. El proyecto fue aprobado por el comité ético institucional. Resultados: en las 65 evaluaciones, se identificó una diferencia estadísticamente significativa en la reducción de los puntajes de los resultados de enfermería Coagulación sanguínea, indicador "hematuria"; Estado circulatorio, en los indicadores "presión arterial sistólica y presión arterial diastólica" y en el Estado de comodidad: física, en el indicador de "bienestar físico". Conclusión: los pacientes evaluados no presentaron mayores complicaciones. Los indicadores clínicos apuntaban a cambios en el estado circulatorio, con reducción presión arterial, así como en la coagulación sanguínea verificada por hematuria, pero sin inestabilidad hemodinámica. El estado de comodidad se vio afectado por el tiempo de descanso posterior al procedimiento.


Resumo Objetivo: avaliar as complicações da biópsia renal percutânea com base nos resultados e indicadores clínicos da Nursing Outcomes Classification. Método: estudo longitudinal prospectivo. A amostra foi de 13 pacientes submetidos à biópsia renal percutânea, com 65 avaliações. Os pacientes foram avaliados em cinco momentos nas 24 horas após o procedimento, por meio de um instrumento desenvolvido pelos pesquisadores com base em cinco resultados (Coagulação sanguínea, Estado circulatório, Gravidade da perda de sangue, Nível de dor, Estado de conforto: físico) e 11 indicadores. Utilizou-se o Teste de Equações de Estimação Generalizadas para comparação entre os escores dos indicadores. O projeto foi aprovado pelo comitê de ética institucional. Resultados: nas 65 avaliações foi identificada diferença estatisticamente significativa na redução dos escores dos resultados de enfermagem Coagulação sanguínea, indicador "hematúria"; Estado circulatório, nos indicadores "pressão arterial sistólica e pressão arterial diastólica" e no Estado de conforto: físico, no indicador "bem-estar físico". Conclusão: os pacientes avaliados não apresentaram complicações maiores. Os indicadores clínicos apontaram alterações no estado circulatório, com redução da pressão arterial, bem como na coagulação sanguínea constatada pela hematúria, porém sem instabilidade hemodinâmica. O estado de conforto foi afetado pelo tempo de repouso após o procedimento.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Outcome and Process Assessment, Health Care , Biopsy , Blood Coagulation , Prospective Studies , Longitudinal Studies , Nephrology Nursing , Hematuria , Hemodynamics , Nursing Process
10.
Journal of Experimental Hematology ; (6): 1685-1689, 2021.
Article in Chinese | WPRIM | ID: wpr-922318

ABSTRACT

Whether in war or peace, timely, effective and accurate hemostasis is an important measure to improve the survival rate and cure rate of the wounded. All the countries in the world are actively developing different types of hemostatic materials so as to reduce the amount of bleeding in an emergency and create favorable conditions for subsequent transport and treatment. At present, the commercialized hemostatic materials are mainly divided into natural biological, synthetic biological, mineral and coagulation components, but all these materials have their own limitations. In this article, the characteristics of chitosan and its derivatives are reviewed as the representatives of the natural organic macromolecular polysaccharide hemostasis materials. Their molecular structures, biomedical properties, domestic and foreign research and application progress as well as comparison with applications of other hemostatic materials are involved. The further research is prospected for optimization and innovation to develop composite chitosan hemostatic materials with the function of hemostasis, antibiosis, pain relief and promoting wound healing.


Subject(s)
Blood Coagulation , Chitosan/pharmacology , Hemorrhage , Hemostasis , Hemostatics , Humans
11.
Article in English | WPRIM | ID: wpr-922124

ABSTRACT

OBJECTIVE@#To investigate the correlation of platelet and coagulation function with blood stasis syndrome (BSS) in coronary heart disease (CHD).@*METHODS@#The protocol for this meta-analysis was registered on PROSPERO (CRD42019129452). PubMed, Excerpta Medica Database (Embase), the Cochrane Library, and China National Knowledge Infrastructure (CNKI) were searched from inception to 1st June, 2020. Trials were considered eligible if they enrolled BSS and non-BSS (NBSS) patients with CHD and provided information on platelet and coagulation function. The platelet function, coagulation function, and fibrinolytic activity were compared between the BSS and NBSS groups. Forest plots were generated to show the SMDs or ESs with corresponding 95% CIs for each study. Subgroup analysis and sensitivity analysis were performed to explore potential sources of heterogeneity.@*RESULTS@#The systematic search identified 1,583 articles. Thirty trials involving 10,323 patients were included in the meta-analysis. The results showed that mean platelet volume, platelet distribution width, platelet aggregation rate, platelet P selectin, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), thromboxane B2 (TXB2), 6-keto-prostaglandin F1alpha (6-keto-PGF1 α), and TXB2/6-keto-PGF1 α were higher in the BSS group than in the NBSS group (P<0.05 or P<0.01). Activated partial thromboplastin time was lower in the BSS group than in the NBSS group in the acute phase of CHD (P<0.01). The R and K values in thromboelastography and tissue plasminogen activator (t-PA) and t-PA/PAI-1 were lower in the BSS group than in the NBSS group (all P<0.01). No difference was found in the results of platelet count, plateletcrit, maximum amplitude, von Willebrand factor, prothrombin time, thrombin time, international normalized ratio, etc. between groups.@*CONCLUSIONS@#Increased platelet function, hypercoagulability, and decreased fibrinolytic activity were found among CHD patients with BSS.


Subject(s)
Blood Coagulation , Blood Platelets , Coronary Disease , Humans , Platelet Aggregation , Tissue Plasminogen Activator
12.
Acta Physiologica Sinica ; (6): 795-804, 2021.
Article in English | WPRIM | ID: wpr-921282

ABSTRACT

Farnesoid X receptor (FXR) has been identified as an inhibitor of platelet function and an inducer of fibrinogen protein complex. However, the regulatory mechanism of FXR in hemostatic system remains incompletely understood. In this study, we aimed to investigate the functions of FXR in regulating antithrombin III (AT III). C57BL/6 mice and FXR knockout (FXR KO) mice were treated with or without GW4064 (30 mg/kg per day). FXR activation significantly prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT), lowered activity of activated factor X (FXa) and concentrations of thrombin-antithrombin complex (TAT) and activated factor II (FIIa), and increased level of AT III, whereas all of these effects were markedly reversed in FXR KO mice. In vivo, hepatic AT III mRNA and protein expression levels were up-regulated in wild-type mice after FXR activation, but down-regulated in FXR KO mice. In vitro study showed that FXR activation induced, while FXR knockdown inhibited, AT III expression in mouse primary hepatocytes. The luciferase assay and ChIP assay revealed that FXR can bind to the promoter region of AT III gene where FXR activation increased AT III transcription. These results suggest FXR activation inhibits coagulation process via inducing hepatic AT III expression in mice. The present study reveals a new role of FXR in hemostatic homeostasis and indicates that FXR might act as a potential therapeutic target for diseases related to hypercoagulation.


Subject(s)
Animals , Antithrombin III , Blood Coagulation , Hepatocytes , Liver , Mice , Mice, Inbred C57BL , Mice, Knockout , Receptors, Cytoplasmic and Nuclear/genetics
13.
Pesqui. vet. bras ; 41: e06988, 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1351274

ABSTRACT

In this study, an outbreak of spontaneous poisoning by Dodonaea viscosa (D. viscosa) in a herd of dairy cattle in the municipality of Capão do Leão, Rio Grande do Sul, was investigated. Three deaths occurred in a batch of 16 Jersey cattle, aged between three and four years, kept in a native field. The clinical signs observed were apathy, decreased production, and anorexia, with death occurring within approximately 48 h after the onset of signs. The three cattle were necropsied, and tissue samples were sent for histopathological examination. Necropsy findings included serosanguineous fluid in the abdominal cavity, intestines with congested serosa, and marked mesenteric edema. The mucosa of the abomasum of two of the animals was hemorrhagic with bloody content, and among the ruminal content of a bovine, leaves with morphological characteristics compatible with D. viscosa were observed. The livers of the three animals were enlarged, with accentuation of the lobular pattern. Histologically, centrilobular coagulation necrosis with congestion and hemorrhage was observed in the liver. Vacuolization and degeneration of hepatocytes were observed in the mid-zonal and periportal regions. The diagnosis of poisoning by D. viscosa leaves was based on epidemiological data, necropsy findings, and histopathological alterations. The presence of the plant in the rumen and in the grazing site of the affected cattle was essential for the diagnosis.(AU)


Neste trabalho, é descrito um surto de intoxicação espontânea por Dodonaea viscosa (D. viscosa) ocorrido em um rebanho de bovinos leiteiros, no município de Capão do Leão, no Rio Grande do Sul. Ocorreram três mortes em um lote de 16 bovinos da raça Jersey com idades entre três e quatro anos, mantidos em campo nativo. Os sinais clínicos observados foram apatia, queda na produção e anorexia, com morte em aproximadamente 48 horas após o início dos sinais. Os três bovinos foram necropsiados, e amostras de tecidos foram encaminhadas para exame histopatológico. Os achados de necropsia incluíam líquido serossanguinolento na cavidade abdominal, intestinos com serosas congestas e marcado edema de mesentério. A mucosa do abomaso de dois animais apresentava-se hemorrágica com conteúdo sanguinolento e, em meio ao conteúdo ruminal de um bovino foram observadas folhas com caracteres morfológicos compatíveis com D. viscosa. O fígado dos três animais estava aumentado, com acentuação do padrão lobular. Histologicamente no fígado havia necrose de coagulação centrolobular com congestão e hemorragia. Nas regiões médio-zonal e periportal observou-se vacuolização e degeneração dos hepatócitos. O diagnóstico de intoxicação pelas folhas D. viscosa foi baseado nos dados epidemiológicos, nos achados de necropsia e nas alterações histopatológicas. A presença da planta no rúmen e no local de pastoreio dos bovinos afetados foi fundamental para o diagnóstico.(AU)


Subject(s)
Animals , Cattle , Poisoning , Blood Coagulation , Hepatocytes , Sapindaceae , Fluconazole , Necrosis
14.
Article in Chinese | WPRIM | ID: wpr-888179

ABSTRACT

This study aims to establish the high-performance liquid chromatography(HPLC) fingerprints of different batches of Notoginseng Radix et Rhizoma, determine their pharmacodynamic indexes of promoting blood circulation, and explore the spectrum-effect relationship between the chemical components of Notoginseng Radix et Rhizoma and the efficacy of promoting blood circulation. Firstly, the HPLC fingerprints of different batches of Notoginseng Radix et Rhizoma were established. Then, the pharmacodynamic indexes were determined after the capillary coagulation experiment and the cerebral ischemia-reperfusion in rats, including capillary coagulation time, percentage of cerebral ischemic area, cerebral water loss rate, and brain-body index. Afterward, the partial least-squares method was used to explore the spectrum-effect relationship between the chemical components of Notoginseng Radix et Rhizoma and the pharmacodynamic indexes. The results showed that this study successfully established the HPLC fingerprints of different batches of Notoginseng Radix et Rhizoma, found 23 common peaks, and identified 12 of them, all of which were saponins. The method was proved stable and reliable. Both the capillary coagulation experiment and the middle cerebral artery occlusion(MCAO)-induced cerebral ischemia-reperfusion experiment on rats revealed that there were obvious differences in the pharmacodynamic indexes of different batches of Notoginseng Radix et Rhizoma. The relationships between 23 common components of Notoginseng Radix et Rhizoma in different batches and the pharmacodynamic indexes were discussed by means of spectrum-effect correlation analysis, of which 17 components had positive effects while 6 components had negative effects on the pharmacodynamic indexes. This study provides a certain reference basis for the clinical rational use and quality control of Notoginseng Radix et Rhizoma.


Subject(s)
Animals , Blood Coagulation , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Quality Control , Rats , Rhizome , Saponins
15.
Article in Chinese | WPRIM | ID: wpr-880441

ABSTRACT

Coagulometer, known as blood coagulation analyzer, is a product that can provide accurate test results for medical diagnosis and treatment analysis by detecting a series of items closely related to thrombosis and hemostasis in coagulation reaction. On the basis of previous traditional methods, and with our deep understanding about the principles of hemagglutination detection, we propose a hemagglutination detection method by using the dual-magnetic circuit beads method. Then, the corresponding hemagglutination detection module is designed. The coagulation time of plasma can be measured by detecting the movement of the magnetic beads when the magnetic field intensity is appropriate. The activated partial thromboplastin time(APTT) of plasma is tested when the most suitable magnetic field intensity is found. The results preliminarily show that this blood coagulation test method is valid and the corresponding test module has a potential value in business.


Subject(s)
Blood Coagulation , Blood Coagulation Tests , Magnetic Phenomena , Magnetics , Partial Thromboplastin Time
16.
Article in Chinese | WPRIM | ID: wpr-880166

ABSTRACT

OBJECTIVE@#To explore the effects of hematocrit (HCT) on the parameters of thromboelastography (TEG) in healthy adults, so as to judge coagulation and fibrinolysis more accurately.@*METHODS@#Three hundred and ninety-three healthy adults examined in Chengdu 363 Hospital Affiliated to Southwest Medical University from May 2018 to May 2019 were selected. HCT and TEG were detected at the same time. The differences of TEG parameters between the high HCT group and the low HCT group were compared. The correlation between HCT and TEG parameters was analyzed. The differences of TEG parameters between the healthy adults in Plateau and plain areas were compared.@*RESULTS@#Among the parameters of TEG, R and K in high HCT group were significantly higher, and Angle, MA and CI were significantly lower than those in low HCT group, which showed statistically significance (P0.05). R and K positively correlated with HCT (r=0.112, 0.517, P=0.027, 0.000), and Angle, MA and CI negatively correlated with HCT (r=-0.490, -0.408, -0.414, P=0.000). LY30 and EPL not correlated with HCT (P>0.05). HCT in plateau area was significantly higher than that in plain area (P0.05).@*CONCLUSION@#The difference of HCT may affect the values of R, K, Angle, MA and CI in TEG parameters. R and K positively correlate with HCT, while Angle, MA and CI negatively correlate with HCT. It is suggested that a suitable TEG reference range for the local population should be established, in plateau area especially K, Angle, MA and CI, which will be more conducive to the accurate evaluation of patients' coagulation and fibrinolysis status.


Subject(s)
Adult , Blood Coagulation , Hematocrit , Humans , Reference Values , Thrombelastography
17.
Article in Chinese | WPRIM | ID: wpr-880122

ABSTRACT

OBJECTIVE@#To compare the plasma components of frozen plasma (FP) and fresh frozen plasma (FFP).@*METHODS@#Twenty samples of FP and 20 samples of FFP from Beijing Red Cross Blood Center were randomly selected. Immediately after plasma melting, 12 plasma components including coagulation factor, fibrinolytic system and anticoagulation protein were detected, including activated partial thromboplastin time (APTT), prothrombin time (PT), coagulation factor Ⅷ (FⅧ) activity, coagulation factor Ⅴ (FⅤ) activity, fibrinogen(FIB) level, ADAMTS-13 activity, von Willebrand factor(vWF) activity, D-dimer (D-dimer, DD), fibrin degradation products (FDP), antithrombin (AT), protein C (PC), and protein S (PS). All these coagulation components between the two types of plasma were compared and analyzed.@*RESULTS@#Compared with FFP, APTT in FP was significantly prolonged(t=3.428, P0.05).@*CONCLUSION@#FP can substitute FFP in the treatment of some diseases, although it is lack of some coagulation factors and anticoagulation protein.


Subject(s)
Beijing , Blood Coagulation , Blood Coagulation Factors , Blood Coagulation Tests , Humans , Plasma
18.
J. bras. econ. saúde (Impr.) ; 12(3): 173-188, Dezembro/2020.
Article in English | LILACS, ECOS | ID: biblio-1141294

ABSTRACT

Objective: The transfusion of blood components and blood products in cardiac surgery patients can be guided by protocols based on standard laboratory tests and/or clinical decisions (Standardof-Care, SOC) or viscoelastic haemostatic assays (VHA). The aim of this study is to evaluate the cost-effectiveness and budget impact of VHAs compared to SOC. Methods: A decision tree model was built in TreeAge Pro® 2009. Costs and benefits were taken from the medical literature. The costeffectiveness was evaluated in a base-case scenario and a worst-case scenario, considering low costs of adverse events. The budget impact was evaluated from data taken from Datasus. Cost data were measured in 2019 USD and outcomes were measured in QALYs. Results: VHAs were considered dominant in the base-case scenario and very cost-effective in the worst-case scenario (ICER = $ 1,083.21 USD/QALY). The budget impact analysis varied from a cost-saving result in the base-case scenario to a reasonable increase in cost in the worst-case scenario. Since the total market share of the technology is unlikely, a reasonable estimative for the base-case scenario and the worst-case scenario are about -$275 million USD and $132 million USD, respectively. Conclusion: We conclude that the VHAs are cost-effective and should be recommended for the use in the perioperative period of cardiac surgeries, especially for patients with a high risk of hemorrhage or coagulation problems.


Objetivo: A transfusão de sangue, hemocomponentes e produtos sanguíneos em pacientes submetidos a cirurgia cardíaca pode ser guiada por protocolos baseados em testes laboratoriais padrão e/ou decisão clínica (Standard-of-Care, SOC) ou testes viscoelásticos (TVEs). O objetivo deste estudo é avaliar o custo-efetividade e o impacto orçamentário dos TVEs em comparação com o SOC. Métodos: Um modelo de árvore de decisão foi construído em TreeAge Pro® 2009. Os parâmetros de custos e benefícios foram obtidos da literatura médica. A relação custo-efetividade foi avaliada em um cenário-base e no pior cenário, considerando baixos custos de eventos adversos. O impacto orçamentário foi avaliado a partir de dados extraídos do Datasus. Os custos foram avaliados em USD 2019 e os desfechos em AVAQs. Resultados: Os TVEs foram considerados dominantes no cenário-base e muito custo-efetivos no pior cenário avaliado (RCEI = 1.083,21 USD/QALY). A análise de impacto orçamentário variou de um resultado de economia de custos no cenário-base a um aumento razoável no custo no pior cenário. Como a hipótese de que a tecnologia será adotada para toda a demanda do mercado é improvável, estimativas razoáveis para o cenário-base e o pior cenário são de aproximadamente -275 milhões de USD e 132 milhões de USD, respectivamente. Conclusão: Concluímos que os VHAs são econômicos e devem ser recomendados para uso no período perioperatório de cirurgias cardíacas, principalmente para pacientes com alto risco de problemas de hemorragia ou coagulação.


Subject(s)
Technology Assessment, Biomedical , Thoracic Surgery , Thrombelastography , Blood Coagulation , Cost-Effectiveness Evaluation
19.
Rev. bras. anestesiol ; 70(6): 635-641, Nov.-Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1155763

ABSTRACT

Abstract Background and objectives: Sugammadex is an alternative pharmacological drug capable of reversing neuromuscular blockades without the limitations that are presented by anticholinesterase drugs. Coagulation disorders that are related to treatment with sugammadex were reported. The exact mechanism of the effects on coagulation are not fully understood. The objective of this research is to evaluate the effects of rocuronium, sugammadex and the rocuronium-sugammadex complex on coagulation in an experimental model in rats. Methods: This is an experimental randomized animal study. Wistar rats were randomly assigned into the following groups: the Control Group; the Ssal Group - 0.5 mL of intravenous saline; the Sugammadex Group - intravenous sugammadex (100 mg kg−1); and the Rocuronium-Sugammadex Group - intravenous solution with rocuronium (3.75 mg kg−1) and sugammadex (100 mg kg−1). Anesthesia was performed by using isoflurane with controlled ventilation. Coagulation factors were measured 10 minutes after the end of the preoperative preparation and 30 minutes after the administration of the drugs in accordance with the chosen groups. Results: Platelet counts, prothrombin times, and activated partial thromboplastin times were similar between the groups and between the moments within each group. There were reductions in the plasma fibrinogen levels between sample times 1 and 2 in the Rocuronium-Sugammadex group (p = 0.035). Conclusions: The rocuronium-sugammadex complex promoted reductions in plasma fibrinogen counts, although the levels were still within normal limits.


Resumo Introdução e objetivos: O sugamadex é uma substância farmacológica alternativa capaz de reverter o bloqueio neuromuscular sem as limitações apresentadas pelos anticolinesterásicos. Entretanto, há relatos de transtornos de coagulação relacionados ao tratamento com sugamadex sem que mecanismos exatos de seus efeitos sobre a coagulação sejam totalmente compreendidos. O objetivo da presente pesquisa foi avaliar os efeitos do rocurônio, sugamadex e do complexo rocurônio-sugamadex sobre a coagulação em um modelo experimental com ratos. Métodos: Este é um estudo randomizado experimental animal. Ratos Wistar foram aleatoriamente designados aos seguintes grupos: grupo controle; Grupo Ssal - 0,5 mL de solução salina intravenosa; Grupo sugamadex - sugamadex intravenoso (100 mg.kg-1); e Grupo rocurônio-sugamadex - solução intravenosa com rocurônio (3,75 mg.kg-1) e sugamadex (100 mg.kg-1). A anestesia foi realizada utilizando-se isoflurano com ventilação controlada. Os fatores de coagulação foram medidos 10 minutos após o final do preparo pré-operatório e 30 minutos após a administração de drogas de acordo com os grupos escolhidos. Resultados: Contagem de plaquetas, tempo de protrombina e tempo de tromboplastina parcial ativada foram semelhantes entre os grupos e entre os momentos dentro de cada grupo. Houve redução nos níveis de fibrinogênio plasmático entre os tempos 1 e 2 no grupo rocurônio-sugamadex (p = 0,035). Conclusões: O complexo rocurônio-sugamadex promoveu reduções na contagem de fibrinogênio plasmático, apesar de os níveis continuarem dentro dos limites normais.


Subject(s)
Animals , Rats , Blood Coagulation/drug effects , Neuromuscular Nondepolarizing Agents/pharmacology , Neuromuscular Blockade , Sugammadex/pharmacology , Rocuronium/pharmacology , Partial Thromboplastin Time , Platelet Count , Prothrombin Time , Fibrinogen/analysis , Random Allocation , Rats, Wistar , Neuromuscular Nondepolarizing Agents/administration & dosage , Anesthetics, Inhalation , Drug Combinations , Sugammadex/administration & dosage , Rocuronium/administration & dosage , Isoflurane , Anesthesia/methods
20.
Acta méd. colomb ; 45(4): 67-67, Oct.-Dec. 2020. graf
Article in English | LILACS, COLNAL | ID: biblio-1278145

ABSTRACT

Un hombre de 72 años, es hospitalizado por falla cardiaca aguda. Tiene historia de hipertensión arterial en manejo con enalapril e hidroclorotiazida. Desde su ingreso, se inició trom-boprofilaxis con enoxaparina 40 mg diarios por vía subcutánea en abdomen. Tres días después aparecen lesiones cutáneas ampollosas, tensas, de contenido hemático y diámetro entre 5-15 mm. Las lesiones se localizan en miembro superior derecho (Figura 1) y pie izquierdo (Figura 2), tienen haloeritematoso y no son dolorosas. Las pruebas de coagulación, proteína C reactiva, VSG y hemograma son normales. Se realizó biopsia de piel que mostró lesión subepidérmica con material hemorrágico en dermis papilar y reticular con neutrófilos escasos, sin vasculitis o trombosis. Estos hallazgos, confirman el diagnóstico de dermatosis ampo-llosa hemorrágica a distancia asociada a enoxaparina. Este constituye un efecto adverso infrecuente y autorresolutivo de las heparinas, no relacionado con la dosificación y en sitios distantes a su aplicación. Este paciente se trató con el retiro del medicamento, resolviendo las lesiones a los sietedías y sin recurrencia de las mismas luego de tres meses de seguimiento


A 72-year-old man was hospitalized for acute heart failure. He had a history of arterial hypertension being treated with enalapril and hydrochlorothiazide. Thromboprophylaxis was begun at admission with 40 mg of subcutaneous enoxaparin daily, in the abdomen. Three days later, tense, blood-filled bullous skin lesions with a 5-15 mm diameter appeared. The lesions were on the right arm (Figure 1) and the left foot (Fig-ure 2); they had an erythematous halo and were not painful Clotting, C-reactive protein, ESR and complete blood count were normal. A skin biopsy was performed, which showed a subepidermal lesion with hemorrhagic material in the papillary and reticular dermis with scant neutrophils and no vasculitis or thrombosis. These findings confirm the diagnosis of bullous hemorrhagic dermatosis at distant sites related to enoxaparin. This is an uncommon and self-resolving adverse effect of heparins, unrelated to the dose and at sites distant from their application. This patient was treated by discontinu-ing the medication, and the lesions resolved seven days later with no recurrence after three months of follow-up.


Subject(s)
Humans , Male , Aged , Skin Diseases , Vasculitis , Patients , Skin , Thrombosis , Wounds and Injuries , Blood Coagulation , Dermis
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