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1.
Vestn Khir Im I I Grek ; 172(3): 73-5, 2013.
Article in Russian | MEDLINE | ID: mdl-24340977

ABSTRACT

The results of study of quantitative functional characteristics of platelets are shown in patients with acute pancreatitis. The patients (57 people) with acute pancreatitis were examined: 40 patients had a mild clinical course of acute pancreatitis and 40 patients had a severe clinical course of acute pancreatitis. The circular functional mass of platelets and the level of TGF-beta1 were determined in dynamics in patients with acute destructive pancreatitis. A correlated analysis was made among the results obtained by means of laboratory and instrumental examinations and clinical course of acute pancreatitis. It was found, that the increase of TGF-beta1 and circular functional mass of platelets in the course of several days was really a good prognostic factor of clinical course of acute pancreatitis. The data obtained showed that the changes of indices of quantitative and functional characteristics of platelets are the important pathogenetic criterion of prognosis for severity of clinical course of acute pancreatitis.


Subject(s)
Blood Platelets/pathology , Pancreatitis, Acute Necrotizing/blood , Transforming Growth Factor beta1/blood , Biomarkers/blood , Female , Follow-Up Studies , Humans , Male , Middle Aged , Platelet Count , Prognosis , Severity of Illness Index
2.
Zh Nevrol Psikhiatr Im S S Korsakova ; 110(12 Pt 2): 23-7, 2010.
Article in Russian | MEDLINE | ID: mdl-21626814

ABSTRACT

The review is devoted to the secondary prevention of ischemic events after ischemic stroke. Recommendations for antithrombotic therapy and prolonged indirect anticoagulant therapy with INR monitoring based on evidence-based medicine of the secondary prevention of ischemic stroke and TIA are presented. Patients who do not need anticoagulants should receive antiplatelet therapy. Due to the increasing number of patients resistant to antiaggregant therapy, the rapid and adequate evaluation of platelet function is needed. Current laboratory diagnostic methods have some shortcomings and do not meet criteria of evidence-based medicine. It is necessary to improve the laboratory diagnosis with the elaboration of reliable standardized methods.


Subject(s)
Anticoagulants/therapeutic use , Fibrinolytic Agents/therapeutic use , Ischemic Attack, Transient/prevention & control , Secondary Prevention , Stroke/prevention & control , Humans
3.
Vestn Khir Im I I Grek ; 167(4): 21-5, 2008.
Article in Russian | MEDLINE | ID: mdl-18942430

ABSTRACT

The complex state of the endothelium function was studied in 25 patients with infective endocarditis in the preoperative and early terms after surgery. A reliable elevation of all indices of endothelium dysfunction independent of the localization of the formed heart disease was detected. Against the background of operative treatment reliable changes demonstrating an improved functional state of the endothelium were noted in the early postoperative period.


Subject(s)
CD59 Antigens/biosynthesis , Endocarditis/diagnosis , Endothelium, Vascular/physiology , Heart Valve Diseases/surgery , Heart Valve Prosthesis Implantation/methods , Adult , Aged , CD59 Antigens/blood , Endocarditis/blood , Endocarditis/complications , Endothelial Cells/immunology , Endothelial Cells/metabolism , Female , Flow Cytometry , Follow-Up Studies , Heart Valve Diseases/diagnosis , Heart Valve Diseases/etiology , Humans , Immunity, Cellular , Male , Middle Aged , Prognosis , Receptors, Complement , Severity of Illness Index , Young Adult
4.
Kardiologiia ; 45(4): 61-3, 2005.
Article in Russian | MEDLINE | ID: mdl-15940194

ABSTRACT

Warfarin is metabolized by cytochrome CYP2C9 and its pharmacokinetic properties depend on structural polymorphisms of CYP2C9 gene. We studied frequencies of allele variants of CYP2C9 gene and associations of individual reaction to warfarin intake with genotype of CYP2C9 gene. Population frequencies of CYP2C9x1, CYP2C9x2, CYP2C9x3 alleles of CYP2C9 gene in St-Petersburg were 82.66, 11.11, and 6.32%, respectively. Carriers of CYP2C9x2 and CYP2C9x3 alleles more rapidly achieved therapeutic levels of hypocoagulation and required significantly lower weekly doses of warfarin.


Subject(s)
Anticoagulants/therapeutic use , Aryl Hydrocarbon Hydroxylases/genetics , DNA/genetics , Gene Frequency , Polymorphism, Genetic , Thrombosis/genetics , Warfarin/therapeutic use , Adolescent , Adult , Aged , Alleles , Anticoagulants/administration & dosage , Anticoagulants/pharmacokinetics , Cytochrome P-450 CYP2C9 , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Genotype , Humans , Male , Middle Aged , Russia , Thrombosis/drug therapy , Thrombosis/metabolism , Treatment Outcome , Urban Population , Warfarin/administration & dosage , Warfarin/pharmacokinetics
5.
Klin Lab Diagn ; (10): 41-4, 2004 Oct.
Article in Russian | MEDLINE | ID: mdl-15584400

ABSTRACT

Patients with artificial heart valves (AHV) belong to a unique multi-component model of the homeostasis system presenting an interaction of activated coagulation processes and pharmacological effects, on the one hand, and genetic peculiarities functioning homeostatic mechanisms, on the other hand. The described method was evaluated on the basis of multi-factor mathematic analysis by information-metry. The data obtained provided for isolating the most information-dense laboratory indices and some genetic polymorphisms describing the shaping of continuous intravascular coagulation of stage III in AHV patients. The clinicians and laboratory experts are offered a practical instrument for the diagnosis (prognostication) of the above condition. It was proven as necessary to examine (by the morphofunctional method) the intravascular activation of platelets and to determine the D-dimer in the remote period after prosthesis of heart valves.


Subject(s)
Heart Valve Prosthesis , Homeostasis , Models, Theoretical , Clinical Laboratory Techniques , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Male , Platelet Activation
6.
Vestn Khir Im I I Grek ; 163(5): 20-4, 2004.
Article in Russian | MEDLINE | ID: mdl-15651689

ABSTRACT

The investigation of the hemostasis system performed in 47 patients with mechanical heart valves (MHV) at the terms of (3.50 +/- 0.25) years included 30 men and 17 women. There were 24 cases of aortal MHV and 23 cases of mitral MHV, I-II functional class (NYHA). The patients were given oral anticoagulants: phenylin to 35 patients (0.009 mg/day), varfarin to 12 patients (52.6 mg/a week). The primary examination of the patients has revealed insufficient anticoagulation protection and clinically asymptomatic permanent intravascular coagulation of the third degree (PIC-3), with the signs of activation of thrombocytic and/or coagulation link of hemostasis. It has been found that a complex assessment of the hemostasis system state including the vascular-thrombocytic link is an obligatory condition of the right choice and timely correction of the PIC-3 in patients with MHV. The methods of correction of impaired hemostasis depend on the primary involvement of the vascular-thrombocytic and/or coagulation link of hemostasis. The pathogenetically selected antithrombotic therapy for patients with MHV allows timely arrest of PIC-3 and less risk of the development of thrombosis and thrombo-embolic complications at long-term periods of observation.


Subject(s)
Blood Coagulation/drug effects , Fibrinolytic Agents/therapeutic use , Heart Valve Prosthesis/adverse effects , Thromboembolism/blood , Thromboembolism/drug therapy , Ticlopidine/analogs & derivatives , Aspirin/therapeutic use , Clopidogrel , Drug Therapy, Combination , Female , Follow-Up Studies , Humans , Male , Nadroparin/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Thromboembolism/etiology , Ticlopidine/therapeutic use , Treatment Outcome
7.
Vestn Khir Im I I Grek ; 163(5): 89-94, 2004.
Article in Russian | MEDLINE | ID: mdl-15651704

ABSTRACT

The genotyping of 40 patients with artificial heart valves (AHV) was performed after prosthesis of the mitral and aotic valves with bicuspid AHV (Medinzh-2 and CarboMedics). The patients took phenylin and varfarin. The patients' genotype was estimated by the thrombophylic genes: factor V Leiden (FVL), prothrombin G20210A, methylene tetrahydrofolate reductase C677T, G/A--455FGB, 4G/5G PAI-1, PI A1/A2 GPIIIa. The genes determining the thrombocytic activity or the vascular wall state substantially influence the third degree of the intensity of the permanent intravascular coagulation (PIC-3) independent of the degree of correction of hemostasis of oral anticoagulants. The addition of anti-aggregants to therapy is the only that can normalize functional activity of thrombocytes in patients with AHV having such defects. The laboratory detection of the genetic defects is of great practical importance for the determination of risk groups of formation of PIC-3 and the strategy of antithrombotic protection of patients with AHV.


Subject(s)
Blood Coagulation Factors/genetics , Blood Coagulation/genetics , Heart Valve Prosthesis Implantation , Thromboembolism/blood , Thrombophilia/genetics , Anticoagulants/therapeutic use , Blood Coagulation/drug effects , Blood Platelets/drug effects , Factor V/genetics , Female , Genotype , Heart Valve Prosthesis Implantation/adverse effects , Humans , Male , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Phenindione/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Prothrombin/genetics , Thromboembolism/genetics , Thromboembolism/prevention & control , Warfarin/therapeutic use
8.
Vestn Khir Im I I Grek ; 162(6): 51-6, 2003.
Article in Russian | MEDLINE | ID: mdl-14997816

ABSTRACT

The observation included 40 patients (20 men and 20 women) with the rheumatic heart diseases acquired at the age of (45.9 +/- 8.7) years after isolated prostheses of the aortal (n = 25) and mitral (n = 15) valves with bicuspid constructions of AHV "MedInzh-2" in remote terms in (2.52 +/- 0.48) years, I-II functional valve (NYHA). It was shown that only a permanent control not rarer than once a month and an adequate correction by means of anticoagulation and antiaggregation therapy using standard methods for patients with the bicuspid AHV made it possible to avoid the development of thromboses and thromboembolic complications during three years of observation.


Subject(s)
Mitral Valve Stenosis/therapy , Pacemaker, Artificial , Thromboembolism/therapy , Thrombosis/therapy , Female , Follow-Up Studies , Humans , Male , Middle Aged , Mitral Valve Stenosis/prevention & control , Thromboembolism/prevention & control , Thrombosis/prevention & control
9.
Vestn Khir Im I I Grek ; 160(5): 21-4, 2001.
Article in Russian | MEDLINE | ID: mdl-11836993

ABSTRACT

An examination of 153 patients with valve replacement was performed at late stages of (6.8 +/- 0.2) years, in 84 patients the mitral valve replacement (MVR) was fulfilled, in 64--the aortic replacement (AVR) and in 5--two valve replacement were performed. Higher indices of hemolysis were noted in patients with AVR, in cases of two valve replacement and in patients with the paravascular fistula. The lowest indices of hemolysis take place in patients with bileaflet prostheses (MEDING/CarboMedics, St. Jude Medical), especially in patients with AVR. The complications of intravascular hemolysis are: cholelithiasis, anemia, hemosiderosis of the kidneys, sideropenia. The timely diagnosis, treatment and prophylactics are necessary to prevent these complications.


Subject(s)
Aortic Valve , Haptoglobins/analysis , Heart Valve Prosthesis/adverse effects , Hemolysis , L-Lactate Dehydrogenase/blood , Mitral Valve , Anemia/diagnosis , Anemia/etiology , Cholelithiasis/diagnosis , Cholelithiasis/etiology , Chronic Disease , Follow-Up Studies , Hemosiderosis/diagnosis , Hemosiderosis/etiology , Humans , Iron Deficiencies , Middle Aged , Time Factors
10.
Vestn Khir Im I I Grek ; 157(3): 60-4, 1998.
Article in Russian | MEDLINE | ID: mdl-9751975

ABSTRACT

The authors share the observations from their cardiosurgical practice showing that one of the causes of sudden death or of rapid worsening of the state of patients with implanted bicuspid artificial valves might be their dysfunction resulting both from breakage of the hinged mechanisms of the valve with its dislocation and migration and from the disturbed mobility of the valve cusp due to a thrombus formed in the atrium. The observations show that the "ideal" construction of the valve is to be created.


Subject(s)
Heart Valve Prosthesis , Prosthesis Failure , Adult , Aortic Valve , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/pathology , Fatal Outcome , Female , Humans , Male , Middle Aged , Mitral Valve
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