Hemostatic variables, carbohydrate metabolism and lipid profile in women with low body mass index.

The aim of this study was to evaluate hemostatic variables in women according to different body mass index (BMI) values, and then correlate them with some metabolic parameters - fasting insulin and glucose, total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides. Eighty-four female patients aged 18-39 years were recruited, and agreed to participate in the study. The study group was divided into three subgroups according to BMI: low BMI (BMI < 18.5 kg/m2; n = 43), normal-weight (control) (BMI 18.5-24.99 kg/m2; n = 21) and overweight/obese (BMI > 25 kg/m2; n = 20). BMI was calculated, and the following measurements were taken: International Normalized Ratio, antithrombin III, tissue plasminogen activator (t-PA) activity, t-PA-antigen, plasma fibrinogen level, factor VII, Plasminogen activator inhibitor (PAI)-1 activity and antigen and metabolic parameters: fasting insulin and glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. The results were statistically analyzed. In the low BMI group, a negative correlation between fasting insulin and PAI-1 activity, and a positive correlation between fasting glucose and PAI-1 antigen were observed. Also, a strong negative correlation between PAI-1 activity and insulin/glucose index was found. Plasma insulin levels were significantly lower in the low-BMI women than in the overweight/obese group (p < 0.001) and with no difference compared to the control group. We did not find any difference in fasting glucose level between all groups. HDL-cholesterol showed the highest levels in the normal BMI group and was significantly higher than in the low BMI and obese groups (p < 0.05 and p < 0.01, respectively). PAI-1 activity in the low BMI women revealed increased activity in comparison to control and overweight/obese women (p < 0.001 and p < 0.05, respectively). Lower antigen levels were also shown as compared to both these groups (p < 0.001 and p < 0.001, respectively). Similar results were obtained with t-PA antigen levels (p < 0.001 and p < 0.001, respectively). There were no differences in activity of t-PA in all groups. Obese women showed significantly higher fibrinogen levels than other BMI groups (p < 0.001 and p < 0.001 respectively). Analysis of hemostatic variables in women with a low BMI testify to the impaired fibrinolysis in this group, also showing a strong correlation with carbohydrate metabolism.

[Assessment of fat tissue distribution impact on selected prothrombin and fibrinolytic factors in pre- and postmenopausal women]. / Ocena wplywu typu rozmieszczenia tkanki tluszczowej na wybrane parametry ukladu krzepniecia i fibrynolizy u kobiet w okresie pre- i pomenopauzalnym.

OBJECTIVES: Objective was to examine the relationship of obesity, body fat distribution fasting plasma insulin concentrations and triglycerides of pro-thrombotic and fibrinolitics factors in pre and postmenopausal women. MATERIAL AND METHODS: We assessed 24 (13 nonobese and 11 obese) postmenopausal and 44 (15 obese and 29 non obese) premenopausal women. Plasma concentration of PAI-1 ag,PAI-1 activity, fibrinogen, tPA-1 akt, tPA ag, von Willebrand factor, fasting plasma insulin, and the lipid pattern (cholesterol, TG, HDL, LDL) was measured. The body fat distribution was assessed by waist-to-hip circumference measuring. RESULTS: Postmenopausal subjects had higher PAI-1 act. and PAI-1 ag (p < 0.05 and 0.001 respectively), vWf and lower ATIII. There was direct correlation between PAI-1 act., Fibrinogen and BMI in both groups of patients together and in premenopausal group PAI-1 act correlated directly and tPA ag/act. indirectly with plasma insulin concentrations. CONCLUSIONS: Plasma concentrations of the pro-thrombotic factors are increased in obese and postmenopausal women and correlate directly with BMI and indirectly with plasma insulin concentrations. Plasma concentrations of anti thrombotic factors indirectly correlated with WHR and with plasma insulin concentrations.

[Evaluation of coagulation and fibrinolysis systems in women at peri- and postmenopausal age qualified for hormone replacement therapy]. / Ocena ukladu krzepniecia i fibrynolizy u kobiet w okresie okolo- i pomenopauzalnym kwalifikowanych do hormonoterapii zastepczej.

OBJECTIVE: The aim of the study was to evaluate coagulation and fibrinolysis systems in peri- and postmenopausal women who were qualified for hormone replacement therapy. MATERIALS AND METHODS: In sixty eight peri- and postmenopausal women qualified for hormone replacement therapy under study some coagulation and fibrinolysis parameters were measured in serum--platelet count, prothrombin time, prothrombin ratio, INR, APTT, thrombin time (TT), fibrinogen, D-dimers, TAT, factor VII, activity of antithrombin III, activity of protein C and protein S, PAI-1 and t-PA concentration. Controls were 26 healthy, reproductive women. RESULTS: Out of fifteen examined coagulation and fibrinolysis parameters in six cases there were statistically significant differences between menopausal women and controls:--APTT and TT were shortened (but within normal range) in menopausal group than in controls;--concentration of fibrinogen in menopausal group (also within normal range) was higher than in controls;--activity of factor VII was risen (and outside normal range) in the examined group in comparison to the controls;--activity of protein S was lower in menopausal than in reproductive women;--also concentration of t-PA was lower in the examined group. CONCLUSIONS: 1. Differences in the values of coagulation and fibrinolytic parameters between the menopausal and reproductive groups of women may testify to the increased risk of thrombus formation in women at peri- and postmenopausal age. 2. Impaired fibrinolysis (low t-PA, high PAI-1) together with the rise in activity of factor VII can contribute to the development of ischaemic heart disease in menopausal women.

[The influence of hormone replacement therapy containing transdermal 17-beta estradiol and oral medroxyprogesterone acetate on coagulation and fibrinolysis]. / Wplyw hormonalnej terapii zastepczej pod postacia przezskórnego 17 beta-estradiolu wraz ze stosowanym doustnie octanem medroksyprogesteronu na uklad krzepniecia i fibrynolizy.

OBJECTIVE: The aim of the study was to evaluate some coagulative and fibrinolytic changes in women taking hormone replacement therapy (HRT). MATERIALS AND METHODS: In 29 women aged 45-64 years with osteoporosis and climacteric symptoms several fibrinolytic and coagulative parameters were measured. These measurements were performed three times in each women--before and after three and six months of HRT containing transdermal 17 beta-estradiol (50 mg per day) and oral medroxyprogesterone acetate (2.5 mg per day). RESULTS: PAI-1 (antigen) and factor VII (activity) were decreased significantly during the trial. No other significant modifications in the examined parameters (fibrinogen, antithrombin III, protein C, protein S, thrombin-antithormbin III complexes, t-PA and D-dimers) were detected. CONCLUSIONS: The hormone replacement therapy can reduce the risk of coronary heart disease thanks to decreased levels of PAI-1 and factor VII. No other changes in coagulation and fibrinolysis were observed during the treatment.

[Ultrasonographic evaluation of pelvis minor and lower extremity veins during pregnancy and puerperium]. / Ocena ultrasonograficzna naczyn zylnych miednicy mniejszej i konczyn dolnych w okresie ciazy i pologu.

Thrombophlebitis of iliac and lower extremity veins is still an actual diagnosis problem in obstetrics and gynaecology. Classical ultrasonography and color doppler usefulness were compared. High efficacy of both methods in early diagnosis was concluded. The color doppler method is more effective in postphlebitic syndrome recognition. Spread out of veins ultrasonography with compression test gives a possibility of early diagnosis of thrombophlebitis in the course of pregnancy and puerperium.

[Carotid-cavernous fistula--diagnostic possibilities of color doppler ultrasonography]. / Przetoka tetniczo-jamista--mozliwosci diagnostyczne kolorowej ultrasonografii dopplerowskiej.

PURPOSE: The diagnosis of carotid-cavernous fistula as a cause of exophthalmus, especially in cases of minor shunts, can be difficult. Angiography is the basic examination of choice is angiography. The aim of the work was to assess the usefulness of colour-coded Doppler ultrasonography (CD-US) in diagnosis of fistulas. MATERIALS AND METHODS: CD-US examinations were analysed in four patients with carotid-cavernous shunts (two post-traumatic, two spontaneous). The diagnosis was confirmed by angiography and computer tomography (CT). RESULTS: Characteristic ultrasonographic appearance in all four cases of fistula was noted. Relation between dynamics of the lesion in CD-US and size of the shunt in CT was found. CONCLUSIONS: CD-US can be recommended both in the initial diagnosis of carotid-cavernous fistulas as well as in follow-up of the treatment.

[Doppler color ultrasonography in the evaluation of orbital and eyeball vessels]. / Kolorowa ultrasonografia dopplerowska w diagnostyce naczyn galki ocznej i oczodolu.

31 persons without any changes in visual system and 16 patients with vascular lesions were examined using Doppler colour ultrasonography. This method allowed to identify and evaluate the blood flow in central retinal artery, ophthalmic artery and in ciliary arteries. The authors described a typical picture of normal eyeball and orbita as well as the blood flow observed with Doppler pulsation wave. It was found that normal orbital veins were difficult to observe. The pathological changes of the blood flow in carotid artery occlusion, in arterial-cavernous shunt and in retrobulbar neuritis were also described. The authors indicate a great diagnostic usefulness of the method.

[Radiotherapy instead of second-line chemotherapy in patients with Hodgkin's disease in partial remission after treatment with cytostatics]. / Radioterapia zamiast chemioterapii "drugiej linii" u chorych na ziarnice zlosliwa w czesciowej remisji po leczeniu cytostatykami.

Radiotherapy was given to 32 patients with Hodgkin's disease (clinical stage IIA-IIIA) in whom chemotherapy given as the first treatment produced partial remission or minimal regression with disappearance of all systemic symptoms (27 cases) or recurrence developed after earlier treatment with cytostatic agents (5 cases). For a more accurate determination of the extent of lesions before radiotherapy in 24 cases laparotomy was done with splenectomy. Radiotherapy given in place of a second course of chemotherapy led in 24 cases (75%) to complete remission lasting from 8 to 62 months, mean 23.2 months. Twenty-one patients are still in continuing remission. These results point to the usefulness of considering the possibility of using radiation energy for the treatment of patients with advanced Hodgkin's disease (phase IIP-IIIP) in whom cytostatic drugs given as a first-line therapy failed to produce complete remission after 4-6 treatment courses, but caused some regression of symptoms with disappearance of systemic signs.

[Use of ultrasound for evaluating structural changes of the renal parenchyma in chronic primary glomerulopathies]. / Zastosowanie badania ultrasonograficznego dla oceny zmian strukturalnych miazszu nerkowego w przewleklych pierwotnych glomerulopatiach.

Ultrasound was used to measure echogenesis, renal cortex thickness and kidney length in 59 patients with various types of the primary glomerulonephritis. The obtained results have shown that the measured parameters correlated with the progress in renal failure. An increase in the intensity of echo from the cortex, thinning of the renal cortex, and the decrease in renal length are typical signs of the advancement of renal failure. As renal function deteriorates in the consequence of destruction of its parenchyma, ultrasound examination might be an illustration of the pathological changes in the kidney. Considering the fact that ultrasound is perfectly safe, it may be used in monitoring of the disease progress and the results of treatment.