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1.
Article in Chinese | WPRIM | ID: wpr-880149

ABSTRACT

OBJECTIVE@#To analyze the relationship between coagulation indexes and prognosis of patients with multiple myeloma (MM).@*METHODS@#A total of 99 newly diagnosed MM patients treated in Gansu Provincial Hospital from October 2017 to October 2019 were enrolled. Plasma thromboplastin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT), and other laboratory indexes were detected. The relationship between coagulation indexes and clinical characteristics of MM patients was analyzed. The differences in survival rates among MM patients with different levels of coagulation indexes were compared, and the effect of each clinical index on the prognosis of MM patients was analyzed by univariate and multivariate.@*RESULTS@#Each coagulation index was correlated to sex, disease classification and stage, and β@*CONCLUSION@#Coagulation function is correlated with multiple clinical indicators of patients with MM and plays an important role in their prognosis.


Subject(s)
Blood Coagulation Tests , Fibrin Fibrinogen Degradation Products , Humans , Multiple Myeloma , Partial Thromboplastin Time , Platelet Count , Prognosis , Prothrombin Time
2.
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
3.
Gac. méd. boliv ; 43(2): 137-142, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1249994

ABSTRACT

Para evaluar la hemostasia preoperatoriamente una historia clínica y examen físico dirigidos están indicados, siendo el uso de pruebas de coagulación recomendados solo cuando existe alguna indicación, y no de rutina; OBJETIVO: el presente estudio pretende conocer la utilidad del TP y APTT en la valoración preoperatorio de coagulopatías en cirugías programadas menores y ambulatorias. MÉTODOS: se realizó un estudio prospectivo, observacional en un hospital quirúrgico terciario; seleccionamos pacientes sometidos a procedimientos menores y ambulatorio, excluyendo aquellos con comorbilidades, riesgo quirúrgico de sangrado alto o con medicación que interfiera con la coagulación. RESULTADOS: se reclutaron 69 pacientes, se aplicó la historia clínica y el examen físico dirigido identificando 1 paciente sospechoso de trastorno de coagulación (posteriormente descartado); Se realizaron 218 exámenes complementarios: 69 rutinarios (TP, APTT, hemograma) y 149 no rutinarios (Indicados de forma arbitraria), obteniendo valores medios en rangos normales y no pudiendo identificar o descartar trastornos de coagulación con ellos, pero observando un 21% (15 casos) resultados anormales, lo que adicionalmente ocasiono conductas para confirmar o corregir estos valores, que van desde repetir la prueba a transfundir hemoderivados; generando un costo promedio global de 102 Bs. por paciente, sin un beneficio o cambio en la conducta clínica o quirúrgica, CONCLUSIÓN: el estudio estableció que las pruebas rutinarias de screening preoperatorio tienen poca utilidad y son poco costo-beneficiosas en la valoración de la hemostasia para procedimientos menores o ambulatorios, en comparación de una historia clínica y examen físico dirigido; siendo apropiada su indicación cuando existan hallazgos anormales en el examen físico e historia clínica o en base a enfermedades concomitantes.


To evaluate hemostasis preoperatively, a directed clinical history and physical examination are indicated, and the use of routine coagulation being recommended when there is some indication, and not routine; OBJECTIVE: the present study aims to know the usefulness of PT and APTT in the preoperative assessment of coagulopathies in scheduled minor and outpatient surgeries. METHODS: a prospective, observational study was conducted in a tertiary surgical hospital; We select patients undergoing minor and outpatient procedures, excluding those with comorbidities, surgical risk of high bleeding, or with medication that interferes with coagulation. RESULTS: 69 patients were recruited, the clinical history and the directed physical examination were applied, identifying 1 patient suspected of coagulation disorder (later discarded); 218 complementary tests were performed: 69 routine (PT, APTT, blood count) and 149 non-routine (arbitrarily indicated), obtaining mean values in normal ranges and not being able to identify or rule out coagulation disorders with them, but observing 21% ( 15 cases) abnormal results (false positives), which additionally led to behaviors to confirm or correct these values, ranging from repeating the test to transfusing blood products; generating a global average cost of 102 Bs. per patient, without a benefit or change in clinical or surgical behavior. CONCLUSION: the study established that routine preoperative screening tests have little utility and are little cost-beneficial in the assessment of the hemostasis for minor or outpatient procedures, compared to a history and directed physical examination; its indication being appropriate when there are abnormal findings in the physical examination and clinical history or based on concomitant diseases.


Subject(s)
Pediatrics , Physical Examination , Prothrombin Time , Surgical Clearance , Hemostasis
5.
Journal of Experimental Hematology ; (6): 1205-1209, 2020.
Article in Chinese | WPRIM | ID: wpr-827139

ABSTRACT

OBJECTIVE@#To analyze the level of coagulation function indexes in patients with lymphoplasmacytic lymphoma (LPL) and its clinical significance.@*METHODS@#The clinical data of 32 patients with initial LPL (LPL group) and physical examination data of 25 healthy persons (control group) who underwent physical examination in our hospital during the same period were collected. The differences of platelet (Plt), D-Dimer (D-D), fibrinogen (Fib), thrombin time (TT), prothrombin time (PT) and activated partial thrombin time (APTT) between the two groups were compared.@*RESULTS@#The Plt count in LPL group [ (137.06±40.14)×10/L] was significantly lower than that in control group [ (215.07±33.25)×10/L], D-D [ (1.01±0.16) mg/L, PT [ (13.01±1.37) s] and APTT [ (40.96±7.24) s] in LPL group were significantly higher than those in control group [ (0.37±0.09) mg/L, (11.96±0.87) s, (25.07±5.13) s] (P<0.01); there was no significant difference in TT and Fib levels between the two groups (P>0.05). There was no significant difference in Plt, D-D, Fib, AP, TT and APTT among LPL patients secreting different types of immunoglobulin (Ig) (P>0.05). After treatment, the coagulation function of LPL patients returned to normal, and no death cases occurred due to hemorrhage or thrombosis.@*CONCLUSION@#LPL patients have hypercoagulable state blood and abnormal coagulation function, but which not closely relates to with the type of Ig secreted by patients.


Subject(s)
Adult , Blood Coagulation , Blood Coagulation Tests , Humans , Lymphoma , Partial Thromboplastin Time , Prothrombin Time , Thrombosis
6.
Article in English | WPRIM | ID: wpr-826628

ABSTRACT

OBJECTIVE@#This study summarizes and compares clinical and laboratory characteristics of 34 patients admitted to the intensive care unit (ICU) for complications from coronavirus disease 2019 (COVID-19) at the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China from Jan. 22 to Mar. 5, 2020.@*METHODS@#A total of 34 patients were divided into two groups, including those who required noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) with additional extracorporeal membrane oxygenation (ECMO) in 11 patients. Clinical features of COVID-19 patients were described and the parameters of clinical characteristics between the two groups were compared.@*RESULTS@#The rates of the acute cardiac and kidney complications were higher in IMV cases than those in NIV cases. Most patients had lymphocytopenia on admission, with lymphocyte levels dropping progressively on the following days, and the more severe lymphopenia developed in the IMV group. In both groups, T lymphocyte counts were below typical lower limit norms compared to B lymphocytes. On admission, both groups had higher than expected amounts of plasma interleukin-6 (IL-6), which over time declined more in NIV patients. The prothrombin time was increased and the levels of platelet, hemoglobin, blood urea nitrogen (BUN), D-dimer, lactate dehydrogenase (LDH), and IL-6 were higher in IMV cases compared with NIV cases during hospitalization.@*CONCLUSIONS@#Data showed that the rates of complications, dynamics of lymphocytopenia, and changes in levels of platelet, hemoglobin, BUN, D-dimer, LDH and IL-6, and prothrombin time in these ICU patients were significantly different between IMV and NIV cases.


Subject(s)
Acute Kidney Injury , Virology , Aged , Aged, 80 and over , Betacoronavirus , Blood Urea Nitrogen , China , Coronavirus Infections , Therapeutics , Extracorporeal Membrane Oxygenation , Female , Fibrin Fibrinogen Degradation Products , Heart Diseases , Virology , Hemoglobins , Hospitalization , Humans , Intensive Care Units , Interleukin-6 , Blood , L-Lactate Dehydrogenase , Blood , Lymphopenia , Virology , Male , Middle Aged , Noninvasive Ventilation , Pandemics , Pneumonia, Viral , Therapeutics , Positive-Pressure Respiration , Prothrombin Time , Retrospective Studies
7.
Article in Chinese | WPRIM | ID: wpr-828548

ABSTRACT

OBJECTIVE@#To observe the clinical effect of plasma exchange and tocilizumab in treatment of patients with severe coronavirus disease 2019 (COVID-19).@*METHODS@#Six patients with severe COVID-19 admitted in First Affiliated Hospital of Bengbu Medical College from January 25 to February 25, 2020. Three patients were treated with plasma exchange and three patients were treated with tocilizumab. The effect on excessive inflammatory reaction of plasma exchange and tocilizumab was observed.@*RESULTS@#The C-reactive protein (CRP) and IL-6 levels were significantly decreased and the lymphocyte and prothrombin time were improved in 3 patients after treatment with plasma exchange; while inflammation level was not significantly decreased, and lymphocyte and prothrombin time did not improve in 3 patients treated with tocilizumab.@*CONCLUSIONS@#For severe COVID-19 patients with strong inflammatory reaction, plasma exchange may be preferred.


Subject(s)
Antibodies, Monoclonal, Humanized , Betacoronavirus , Coronavirus Infections , Blood , Allergy and Immunology , Therapeutics , Cytokine Release Syndrome , Therapeutics , Humans , Pandemics , Plasma Exchange , Reference Standards , Pneumonia, Viral , Blood , Allergy and Immunology , Therapeutics , Prothrombin Time , Treatment Outcome
8.
Korean Circulation Journal ; : 163-175, 2020.
Article in English | WPRIM | ID: wpr-786221

ABSTRACT

BACKGROUND AND OBJECTIVES: Although anticoagulation with warfarin is recommended as an international normalized ratio (INR) of prothrombin time between 2.0 and 3.0 and mean time in the therapeutic range (TTR) ≥70%, little has been proven that universal criteria might be suitable in Korean atrial fibrillation (AF) patients.METHODS: We analyzed 710 patients with non-valvular AF who took warfarin. INR value and clinical outcomes were assessed during 2-year follow-up. Intensity of anticoagulation was assessed as mean INR value and TTR according to target INR range. Primary net-clinical outcome was defined as the composite of new-onset stroke and major bleeding. Secondary net-clinical outcome was defined as the composite of new-onset stroke, major bleeding and death.RESULTS: Thromboembolism was significantly decreased when mean INR was over 1.6. Major bleeding was significantly decreased when TTR was over 70% and mean INR was less than 2.6. Mean INR 1.6–2.6 significantly reduced thromboembolism (adjusted hazard ratio [HR], 0.40; 95% confidence interval [CI], 0.19–0.85), major bleeding (HR, 0.43; 95% CI, 0.23–0.81), primary (HR, 0.50; 95% CI, 0.29–0.84) and secondary (HR, 0.45; 95% CI, 0.28–0.74) net-clinical outcomes, whereas mean INR 2.0–3.0 did not. Simultaneous satisfaction of mean INR 1.6–2.6 and TTR ≥70% was associated with significant risk reduction of major bleeding, primary and secondary net-clinical outcomes.CONCLUSIONS: Mean INR 1.6–2.6 was better than mean INR 2.0–3.0 for the prevention of thromboembolism and major bleeding. However, INR 1.6–2.6 and TTR ≥70% had similar clinical outcomes to INR 2.0–3.0 and TTR ≥70% in Korean patients with non-valvular AF.


Subject(s)
Atrial Fibrillation , Follow-Up Studies , Hemorrhage , Humans , International Normalized Ratio , Prothrombin Time , Risk Reduction Behavior , Stroke , Thromboembolism , Warfarin
10.
Hematol., Transfus. Cell Ther. (Impr.) ; 41(1): 31-36, Jan.-Mar. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002046

ABSTRACT

Abstract Introduction Type 2 diabetes mellitus, characterized by insulin resistance, corresponds to approximately 90% of cases of diabetes worldwide. Hyperglycemia in diabetes contributes to hyperfibrinogenemia and activates the coagulation cascade thereby producing atherothrombotic events. Objectives This study was designed to evaluate the coagulation profile (activated partial thromboplastin time, prothrombin time and fibrinogen) in Type 2 diabetes and to analyze correlations between body mass index, fasting blood glucose, glycated hemoglobin and duration of diabetes with coagulation parameters. Methods This study included 60 type 2 diabetics and 30 controls. Diabetic patients were grouped in two sets based on the presence or absence of microvascular complications. The demographic profile and clinical details were recorded. Fasting blood glucose, glycated hemoglobin, coagulation parameters such as prothrombin time, activated partial thromboplastin time and fibrinogen along with other biochemical parameters were investigated. Results There were statistically significant differences in the coagulation parameters between the two groups of diabetics (with and without complications). The present study also found significant correlations between age and the duration of diabetes with and without complications and coagulation parameters such as the activated partial thromboplastin time, which was found to be significantly lower, and fibrinogen, which was found to be significantly higher in subjects with complications compared to subjects without complications. Conclusion Clinical tests for prothrombin time, activated partial thromboplastin time and fibrinogen are relatively inexpensive and readily available. The present study shows that shortened prothrombin time, activated partial thromboplastin time and increased fibrinogen levels might be useful hemostatic markers in diabetic patients, especially in those at high-risk for thrombotic complications.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Partial Thromboplastin Time , Prothrombin Time , Diabetes Mellitus, Type 2 , Glycemic Control
11.
Rev. bras. anal. clin ; 51(1): 52-57, 30/03/2019. graf
Article in Portuguese | LILACS | ID: biblio-1008205

ABSTRACT

Objetivo: Analisar os testes de coagulação: tempo de protrombina (TP) e tempo de tromboplastina parcial (TTP) em diferentes tempos de centrifugação da amostra da biológica, com relação ao protocolo padrão do Clinical Laboratory Standards Institute (CLSI). Métodos: As amostras foram divididas em cinco alíquotas de 1 mL. Foi realizada a centrifugação em 15, 10, 5, 2 e 1 minuto, com velocidade de 1500 g. O TP e TTP foram imediatamente analisados em aparelho automatizado. Os plasmas foram analisados para presença de elementos residuais: eritrócitos, leucócitos e plaquetas. Resultados: Observou-se alteração dos valores do TP nos tempos de centrifugação 10, 5, 2 e 1 minuto e do TTP em 5, 2 e 1 minuto, com relação ao protocolo padrão. Na interpretação de Bland Altman, observou-se um viés significativo do limite clínico aceitável para o TP e para o TTP em todos os tempos de centrifugação, com relação ao protocolo padrão. Apenas no tempo de centrifugação de 15 minutos não foram encontradas células residuais nas amostras analisadas. Conclusão: O tempo de centrifugação de 15 minutos é o ideal para remoção completa das células sanguíneas residuais e para garantia da confiabilidade dos resultados dos testes de coagulação TP e TTP.


Objective: To analyze the coagulation tests: prothrombin test (PT) and partial thromboplastin time (PTT) in different centrifugation times of the sample, in relation to the standard protocol of the Clinical Laboratory Standards Institute (CLSI). Methods: The selected samples were splitted up into five aliquots of 1 mL. Centrifugation of these aliquots was carried out at 15, 10, 5, 2 and 1 minute at 1500 g. The PT and PTT were analyzed in an automated apparatus. The plasmas were analyzed for presence of residual elements: erythrocytes, leukocytes and platelets. Results: The results showed a change in the values of PT at the 10, 5, 2 and 1 minute centrifugation times and the PTT at 5, 2 and 1 minutes, relative to the standard protocol. In the interpretation of Bland Altman, a significant bias of the acceptable clinical limit for TP and TTP at all centrifugation times was observed, relative to the standard protocol. Only in the 15 minute centrifugation time no residual cells were found in the analyzed samples. Conclusion: The present study demonstrated that the 15-minute centrifugation time is ideal for complete removal of residual blood cells and to ensure the reliability of the results of the PT and PTT coagulation


Subject(s)
Humans , Male , Female , Prothrombin Time , Blood Coagulation Tests , Centrifugation
12.
Nigerian Hospital Practice ; 23(4-5): 49-55, 2019.
Article in English | AIM, AIM | ID: biblio-1267717

ABSTRACT

Occupational exposure to wood dust may bring about some changes in blood indices of humans, especially in developing countries where use of protective gadgets like face masks are not in use. This study is aimed at evaluating changes in blood cell indices, haemostasis and CD 4 count on occupationally exposed workers to wood dust. This randomized study consisted of one hundred (100) male sawmill workers who have been exposed to wood dust by working in these environments without any form of protective masks, for over two years as test subjects and fifty male individuals randomly selected who were not exposed to wood dust as controls. Blood samples were obtained from these workers and analysed for complete blood count using PCE ­ 210N haematology analyser, prothnumbin time test (PTT) and activated partial thromboplastin (APTT) were manually done using commercially purchased kit and CD4 count was performed using the flow cytometry method. Haemoglobin, haemcitrocrit and granutocyte levels increased significantly in test subjects when compared with control subjects (P= 0.037, P=0.026, p=0.0005. Mean lymphocyte levels decreased significantly in test when compared to control subjects (P=0.028). while there were no changes in the other CBC parameters, PT, APTT and CD4 counts in test when compared with control subjects. This suggest that inhalation of wood dust increases haemotocrit, haemoglobin and granulocyte levels, decreased lymphocyte count and a longer exposure time to wood dust significantly affects these parameters. This may imply there is an increased rate of blood flow in the circulation of these individuals


Subject(s)
Blood , Inhalation , Lakes , Nigeria , Prothrombin Time , Rheology
13.
Yonsei Medical Journal ; : 440-445, 2019.
Article in English | WPRIM | ID: wpr-742562

ABSTRACT

PURPOSE: Patients with liver cirrhosis are considered to be at risk for additional adverse events during endoscopic retrograde cholangiopancreatography (ERCP). The present study was designed as a propensity-score matched analysis to investigate whether cirrhotic liver increases the risk of bleeding complications in patients undergoing ERCP. MATERIALS AND METHODS: In total, 8554 patients who underwent ERCP from January 2005 to December 2015 were retrospectively analyzed. To adjust for the imbalance between patients with and those without liver cirrhosis, 1:3 propensity score matching was performed according to age and sex. RESULTS: Liver cirrhosis was identified in 264 (3.1%) patients. After propensity score matching, a total of 768 patients were included in each of the cirrhotic (n=192) and non-cirrhotic groups (n=576). Post-procedure bleeding (10.9% vs. 4.7%, p=0.003) was more frequently observed in patients with liver cirrhosis than in those without. In multivariate analyses, liver cirrhosis was identified as an independent risk factor associated with post-ERCP bleeding (p=0.003) after further adjustment for prothrombin time, antiplatelet/coagulant, duration of ERCP, and stent insertion. Child-Pugh (CP) class C was found to be associated with an increased incidence of post-ERCP bleeding in patients with cirrhosis (odds ratio 6.144, 95% confidence interval 1.320–28.606; p=0.021). CONCLUSION: The incidence of post-ERCP bleeding in patients with liver cirrhosis was higher than that in patients without liver cirrhosis. In particular, CP class C cirrhosis was significantly associated with post-ERCP bleeding.


Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Fibrosis , Hemorrhage , Humans , Incidence , Liver Cirrhosis , Liver , Multivariate Analysis , Propensity Score , Prothrombin Time , Retrospective Studies , Risk Factors , Stents
14.
Journal of Liver Cancer ; : 59-63, 2019.
Article in English | WPRIM | ID: wpr-765703

ABSTRACT

We present a case of spontaneous rupture of hepatocellular carcinoma with poor liver function managed by transcatheter arterial embolization (TAE). The patient's bilirubin level was 2.1 mg/dL, albumin level was 2.4 g/dL, and prothrombin time international normalized ratio was 2.1. In addition, the patient had also developed a large number of ascites. The tumor was supplied by the right renal capsular artery, as observed on angiography. With successful TAE, no hepatic failure occurred. We believe TAE can be a safe and effective treatment option, even in patients with poor liver function, if tumors are supplied only by extrahepatic collateral vessels.


Subject(s)
Angiography , Arteries , Ascites , Bilirubin , Carcinoma, Hepatocellular , Humans , International Normalized Ratio , Liver , Liver Failure , Prothrombin Time , Rupture, Spontaneous
15.
Article in English | WPRIM | ID: wpr-759982

ABSTRACT

Intramuscular hematomas on the psoas muscle are rare and usually occur as a result of trauma, iatrogenic etiology during lumbar surgery, rupture of the aortic aneurysm, and hematologic diseases. The incidence of spontaneous psoas muscle hematomas has slowly increased as a result of using anticoagulation and antiplatelet agents. Magnetic resonance (MR) imaging is a more sensitive option compared to computed tomography (CT) when diagnosing a hematoma. Coronal T2-weighted images are more useful. CT imaging is also useful to establish the rapid diagnosis of hematoma. When a prolonged prothrombin time and international normalized ratio and decrease platelet count are noted, psoas muscle hematomas should be considered, if there was no lesion in the spinal canal. Most hematomas resolve spontaneously without clinical complications if the hematoma is not large or it is not compressing the surrounding important structures, irrespective of cause.


Subject(s)
Aortic Aneurysm , Diagnosis , Hematologic Diseases , Hematoma , Incidence , International Normalized Ratio , Magnetic Resonance Imaging , Platelet Aggregation Inhibitors , Platelet Count , Prothrombin Time , Psoas Muscles , Rupture , Spinal Canal
16.
Article in Korean | WPRIM | ID: wpr-758473

ABSTRACT

OBJECTIVE: Unperforated and perforated acute appendicitis need to be differentiated because appendicitis with a free perforation requires an emergency operation to prevent contamination inside the bowel from spreading into the peritoneal cavity. The sensitivity of imaging tests is not reliable enough alone for determining the existence of a perforation. The aim of this study was to determine the differences in laboratory values between unperforated and perforated acute appendicitis to help distinguish perforated acute appendicitis. METHODS: The laboratory values and demographic data of a total of 175 patients who visited the emergency room and were diagnosed with acute appendicitis were collected. The time elapsed from symptom presentation to the ER visit, length of admission, patient demographics, and laboratory values, including sex, age, leukocyte count, neutrophil %, neutrophil count, C-reactive protein (CRP), platelet count, prothrombin time (PT), activated partial thromboplastin time, international normalized ratio (INR), serum glucose, blood urea nitrogen, creatinine, total and direct bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and gamma-glutamyltransferase were analyzed. RESULTS: The factors associated with appendix perforations were an elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose and total bilirubin; and delayed PT and INR. CONCLUSION: Acute appendicitis patients without definite imaging evidence of the perforation but with the laboratory values suggesting a perforation, such as elevated leukocyte count, neutrophil count, neutrophil %, CRP, serum glucose, and total bilirubin; and delayed PT, and INR should raise concern for a possible undiscovered perforation.


Subject(s)
Abdomen, Acute , Alanine Transaminase , Alkaline Phosphatase , Appendicitis , Appendix , Aspartate Aminotransferases , Bilirubin , Blood Glucose , Blood Urea Nitrogen , C-Reactive Protein , Creatinine , Demography , Diagnosis, Differential , Emergencies , Emergency Service, Hospital , gamma-Glutamyltransferase , Humans , International Normalized Ratio , Leukocyte Count , Neutrophils , Partial Thromboplastin Time , Patient Admission , Peritoneal Cavity , Platelet Count , Prothrombin Time
17.
Article in Korean | WPRIM | ID: wpr-762276

ABSTRACT

BACKGROUND: Biliary atresia is an extrahepatic progressive obliterate cholangiopathy that occurs in infants. Kasai procedure, a surgical method that can help re-establish bile flow from the liver into the intestine, is its first line treatment. Since infants with biliary atresia already have advanced hepatic dysfunction, all kinds of schemes should be considered to minimize further liver damage during surgery. The objective of this study was to compare the postoperative hepatic functions between the two commonly used inhalational anesthetics in infants undergoing the Kasai procedure (i.e., desflurane and sevoflurane). METHODS: This prospective, randomized, double-blind, single-center, and parallel group study included 40 children undergoing Kasai procedure. They were randomly allocated to Group S (sevoflurane) or Group D (desflurane). All the patients were anesthetized with designated anesthetic agent with the end-tidal concentration of about 0.8–1 minimum alveolar concentration. Postoperative hepatic functions were assessed by aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, prothrombin time, and total bilirubin. RESULTS: A total of 38 patients were selected for the study. In both groups, AST, ALT were increased in magnitude to the peak on postoperative day 0 and decreased to preoperative value at postoperative day 3. There were no significant differences between the groups in any laboratory results related to liver function. CONCLUSIONS: Sevoflurane and desflurane, inhalation anesthetics for maintaining anesthesia used in infants undergoing the Kasai procedure, did not show any difference in preserving postoperative hepatic function.


Subject(s)
Alanine Transaminase , Anesthesia , Anesthetics , Anesthetics, Inhalation , Aspartate Aminotransferases , Bile , Biliary Atresia , Bilirubin , Child , Humans , Infant , Intestines , Liver , Liver Function Tests , Methods , Portoenterostomy, Hepatic , Prospective Studies , Prothrombin Time
18.
Yonsei Medical Journal ; : 626-632, 2019.
Article in English | WPRIM | ID: wpr-762098

ABSTRACT

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.


Subject(s)
Adult , Arthroplasty, Replacement, Knee , Blood Platelets , Capillaries , Erythrocyte Aggregation , Fibrinogen , Heparin, Low-Molecular-Weight , Humans , Incidence , Plasma , Prothrombin Time , Research Subjects , Thromboplastin , Venous Thrombosis , Viscosity
19.
Article in Korean | WPRIM | ID: wpr-741143

ABSTRACT

BACKGROUND: Prothrombin time (PT) measurement is an important test for screening blood coagulation disorders and monitoring anticoagulant therapy. In this study, we evaluated the analytical performance of HemosIL ReadiPlasTin (Instrumentation Laboratory, USA), a liquid reagent for PT measurement. METHODS: The precision of HemosIL ReadiPlasTin was evaluated according to the Clinical and Laboratory Standards Institute (CLSI) EP5-A3 guidelines. Further, comparison with HemosIL RecombiPlasTin 2G (Instrumentation Laboratory, USA) was made according to the CLSI EP9-A3 guidelines. The reference intervals were established according to the CLSI C28-A3 guidelines. RESULTS: The coefficient of variation values for repeatability and total imprecision at two levels of control materials were lower than 1.1% and 3.4%, respectively. The performance of HemosIL ReadiPlasTin was comparable to that of HemosIL RecombiPlasTin 2G, with a high correlation (r=0.996). The reference interval for normal subjects was 10.4–13.3 seconds. CONCLUSIONS: HemosIL ReadiPlasTin showed an acceptable degree of imprecision and its performance showed high correlation with that of a conventional reagent. Therefore, it is expected to be useful for PT measurement in clinical laboratories.


Subject(s)
Blood Coagulation Disorders , Blood Coagulation Tests , Mass Screening , Prothrombin Time , Prothrombin , Thromboplastin
20.
Article in Chinese | WPRIM | ID: wpr-774117

ABSTRACT

OBJECTIVE@#To study the correlation between coagulation function and gestational age in preterm infants and the possible value of coagulation function measurement in predicting hemorrhagic diseases.@*METHODS@#The clinical data of preterm infants who were hospitalized between September 2016 and August 2017 were collected. The coagulation indicators were measured within 2 hours after birth. According to the gestational age, the preterm infants were divided into late preterm infant group (n=322), early preterm infant group (n=241) and extremely/very early preterm infant group (n=128). Coagulation function was compared among the three groups, as well as between the preterm infants with and without hemorrhagic diseases within 3 days after birth.@*RESULTS@#There were significant differences in thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen degradation product (FDP) and D-dimer (DD) among the three groups (P<0.05). APTT, PT, FDP and DD were negatively correlated with gestational age, while TT was positively correlated with gestational age (P<0.05). The preterm infants with hemorrhagic diseases had a longer APTT and a higher level of DD (P<0.05).@*CONCLUSIONS@#Coagulation function gradually becomes mature in preterm infants with the increase in gestational age. Abnormal APTT and DD indicate that preterm infants may have a higher risk of hemorrhagic diseases.


Subject(s)
Blood Coagulation , Blood Coagulation Tests , Gestational Age , Humans , Infant, Newborn , Partial Thromboplastin Time , Prothrombin Time
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