The behavior of amidolytic factor VII in smoking and non-smoking pregnant women in relation to their gestational age.

OBJECTIVE: Aim of the study was to assess the behavior of factor VII by commercial amidolytic assay in smoking and non-smoking pregnant women, and to compare this with the earlier reported factor VII:C levels during pregnancy and to discuss the role of F VII:Am with regard to thromboembolic complication in smoking pregnant women. METHODS: Blood samples were obtained for 75 non-smoking pregnant women and 109 smoking pregnant women. For the chromogenic determination of F VII:Am a COA-Set F VII test kit from Kabi Vitrum was used. Correlations were calculated by the Spearman rank method. The Mann-Whitney-U test was used for the statistical comparison of the median values of the smoking and non-smoking groups. RESULTS: Both the smoking and non-smoking group displayed a significant increase of F VII:Am with gestational age (r=0.53; p<0.0001 for smokers and r=0.55; p=0.005 for non-smokers). The median concentration of F VII:Am was significantly higher in stage 3 (226%-211%) and stage 4 (262%-230%) in the smoking group. CONCLUSION: As elevated F VII:C levels have been described to be a risk factor for thrombotic events, the even higher than normally already enhanced plasma levels of FVII:Am in smoking pregnant women may indicate an additional risk for both thrombosis in the pregnant and for an increased fetal morbidity and even mortality caused by thrombotic processes in the uteroplacental vasculature. The results from the present study might be an extra argument to advise pregnant women not to smoke or to quit smoking during pregnancy.

Haemostasis activation markers in plasma of patients with benign and malignant gynaecological tumours: a pilot study.

Coagulation and fibrinolysis activation have been investigated in fifty-eight women with recently detected gynaecological tumours. Twenty-six were benign and 32 malignant: of the last group nine patients had metastases. A control group consisted of 31 age-matched healthy women. Prothrombin fragment 1 + 2, thrombin-antithrombin III and D-dimer were measured. The median values of all analytes were significantly higher in the malignant tumour group, but not in the benign tumour group, as compared to the control group. The group of patients with a gynaecological tumour and metastases differed from the non-metastasized tumour group in prothrombin fragment 1 + 2, thrombin-antithrombin III and D-dimer. In the non-metastasized malignant tumour group solely prothrombin fragment 1 + 2 was significantly higher than in the benign tumour group. Coagulation and fibrinolysis predominating as can be derived from the elevated D-dimer/thrombin-antithrombin III and D-dimer/prothrombin fragment 1 + 2 ratios. The studied constituents do not enable a differentiation between the benign and malignant processes. However, as the differences of these values in both malignant tumour groups were significant, this might be used to trace the existence of metastases in gynaecological tumours. Investigation of these analytes in several specific types of gynaecological tumours might be clinically relevant.

Fibrinogen and factor VII in male neonates.

Recent studies have suggested that retarded fetal and early growth predisposes to cardiovascular disease of males in adult life. This is partly explicable by an association between the haemostatic variables fibrinogen and factor VII and the placenta/birth weight ratio. Since many characteristics influence clotting factors during life, levels of fibrinogen and clotting factor VII were measured in cord blood of male neonates. The placenta/birth weight ratio did not correlate with the birth weight for gestational age and appeared to be only a minor indicator of fetal growth. These findings make it unlikely that the level of fetal outcome 'programmes' male neonates via fibrinogen or factor VII to develop cardiovascular disease in adult life.

Cord blood clotting factors in neonates of smoking and non-smoking mothers.

Since smoking is known to influence hemostasis, the possible impact of maternal smoking on hemostatic variables in the newborn was studied. Cord blood clotting factors fibrinogen, factor VII, factor VIII:c and factor XIII were measured in 151 newborns. A significant reduction in birth weight and a rise in the placental/birth weight ratio was found in newborns of smoking mothers, which is in agreement with the literature. No differences in cord blood clotting factors were found between the smoking and non-smoking groups. A possible explanation for this, at least for lack of difference in fibrinogen levels, may be that fetal lungs were not directly exposed to smoke.

Benign abdominal multicystic mesothelioma.

The benign abdominal multicystic mesothelioma is a rare disease. Usually a malignancy of the ovary is suspected prior to and during surgery. The histological diagnosis and the clinical course however are benign. Three cases are reported. Diagnosis, treatment and follow up are discussed.

Single-dose oral fluconazole versus single-dose topical miconazole for the treatment of acute vulvovaginal candidosis.

OBJECTIVES: To compare efficacy, safety and patient preference of a single oral dose of 150 mg fluconazole with a single intravaginal dose of 1200 mg miconazole in vaginal candidosis. To investigate the effect of treatment on Candida colonization of throat and rectum. DESIGN: Double-blind, double-dummy, parallel, randomized trial. Ninety-nine patients with symptomatic and mycologically verified candidosis were given 150 mg fluconazole with an intravaginal dummy, or 1200 mg miconazole with an oral dummy. Patients with an inadequate short-term response were given a second dose. RESULTS: At each visit a patient self assessment and an investigators' global assessment were recorded, and cultures were set up. Adverse events were recorded and laboratory tests were performed. Clinical cure or improvement (investigators' assessment) was obtained in 100% (short-term) and 95% (long term) of the fluconazole group and in 94% and 90%, respectively, of the miconazole group. Patients considered the treatment excellent or good in 81% (short-term) and 88% (long-term) in the fluconazole group and in 84% and 76%, respectively, of the miconazole group. Mycological cure was achieved in 98% (short-term) and 73% (long-term) of the fluconazole group and in 96% and 82% respectively in the miconazole group. The differences in results were not significant. Both treatments significantly reduced the number of positive rectal cultures: neither treatment had a significant effect on throat cultures. Four percent of the patients preferred intravaginal therapy. CONCLUSION: A single dose fluconazole is as safe and effective as a single dose of miconazole.