Coagulation and fibrinolytic abnormalities in Behcet's Disease

12 patients with Behcet's disease were investigated using a wide panel of coagulation and fibrinolytic studies including plasminogen, tissue plasminogen activator [tPA] plasminogen activator inhibitor [PAI-1], alpha2 antiplasmin, von Willebr and factor [vWF], as well as tests for thrombin generation, thrombin-antithrombin III complex [TAT] and D- dimer. 6 matched volunteers served as controls. Neither patients nor controls had history or clinical evidence of thromboembolic disease. Patients with Behcet's disease showed significantly elevated fibrinogen [P <0.05], vWF [P <0.001] and TAT [P <0.001] compared to controls, while D-dimer was unchanged. As regards the fibrinolytic system, there was a significant elevation of PAI-1 [P <0.01] with normal levels of tPA, plasminogen and alpha2 antiplasmin in patients compared to controls

Thrombin generation and thrombin-antithrombin complex formation in patients with ischemic heart disease: diagnostic importance and impact of thrombolysis

50 patients with ischemic heart disease were included in the study. 20 patients with stable angina pectoris formed group I. Group II was formed of 10 patients suffering from unstable angina, and group III included 20 patients with documented transmural acute myocardial infarction. Group II and III patients were studied at presentation, before the administration of anticoagulants or thrombolytic therapy. Patients with diabetes, end stage renal disease or severe hepatic impairment were not included in the study. Ten normal healthy age-sex matched volunteers served as controls. Patients and controls were thoroughly clinically examined and subjected to routine electrocardiography to Document the diagnosis and cardiac enzymes [CPK, LDH, SGOT] were estimated for groups II and III patients. Patients and controls were subjected to routine coagulation studies [PT and PTT] and the assay of thrombin-antithrombin III complex [TAT] using an ELISA technique [Enzygnost TAT], Behring. TAT level was reassayed in 15 of group III patients 3 hours after the administration of 1.5 million units of streptokinase and before the start of heparin therapy

sensitive marker of disease activity in patients with systemic lupus erythematosus: serum neopterin

Serum neopterin was assayed in 24 patients with systemic lupus erythematosus [SLE] under various treatment modalities with variable control and compared to 10 healthy age-sex matched volunteers. Patients were followed up for a duration of six months for any evidence of disease activity and were restudied during the earliest disease exacerbation. Serum C3, C4 and circulating immune complexes [CIC] were also assayed as well as ESR as markers of disease activity. C-reactive protein [CRP] was estimated initially and during the disease exacerbation to rule out infections. Patients with positive CRP were excluded from the study. Serum neopterin was significantly elevated among patients when compared to controls. Neopterin level seemed to be a supersensitive marker of disease activity correlating firmly with CIC and with the consumption of C3 predicting early relapse of lupus activity even before the drop of C3. It neither correlated with C4 nor with nonspecific parameters such as the erythrocyte sedimentation rate. Serum neopterin may serve as a supersensitive but nonspecific marker of disease activity in patients with SLE and if used in conjunction to specific markers, its prognostic value may be great

Insulin bioavailability and glycemic time response to porcine, bovine and human regular insulin in the management of insulin dependent diabetes

One of the major difficulties in maintaining normoglycemia in patients with insulin-dependent diabetics relates to the failure of subcutaneous injections to duplicate or simulate the normal release from the pancreas. The raid surge in circulating insulin with nutrient intake is very difficult to achieve even with well-timed preprandial injections of regular insulin. It was attempted to compare the bioavailability of the various regular insulin preparations [porcine, bovine and human] after stabilizing the various factors that might be involved in the process of insulin absorption and delivery. There was no statistically significant difference in the glycemic control for each patient and for the patients collectively when porcine, bovine or human insulin were used [P >0.05], neither was there any difference in the free insulin level with the three preparations [P >0.05]. The most repair glucose response was observed with human insulin peaking in less than 2 hours. Response to porcine and bovine insulin were more delayed 3 and 4 hours, respectively. The hypoglycemic and free insulin time responses to human insulin bears the closest relation to the normal insulin response curve. If bovine or porcine preparations are to be used, preprandial injections should be properly timed