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Biomedical subjects

A Girolami

Publications and source records attributed to A Girolami.

At least 487 records · Page 27Linked to original sources

The release of beta-thromboglobulin and platelet factor 4 during extracorporeal circulation for open heart surgery.

Cardiopulmonary bypass is extremely damaging to platelets and it causes a quantitative and qualitative alteration in their functions. We evaluated the release of two platelet-specific proteins, beta-thromboglobulin (beta TG) and platelet factor 4 (PF4), in patients who underwent extracorporeal circulation for open heart surgery. A parallel release (basal value beta TG: 119.6 ng/ml, PF4 30 ng/ml) was present for both proteins in a time dependent fashion until the end of extracorporeal circulation. High average levels were observed in patients in whom the bypass was stopped after about 1 h (beta TG 1606 ng/ml, PF4 745 ng/ml) and similarly in those in whom the bypass was stopped after about 2 h (beta TG 1540 ng/ml, PF 4754 ng/ml). No correlation was found either between the level of PF4 and the additional heparin administered after the initial standard dose (r = 0.29, P greater than 0.10) and between the level of PF4 and the amount of heparin consumed during the bypass (r = 0.05, P greater than 0.5).

Beta-Globulins↗

Rheological and fibrinolytic findings in multiple sclerosis.

Blood viscosity indices, fibrinolytic activity and other serum proteins related to haemocoagulation have been studied in 36 patients with multiple sclerosis. The whole blood viscosity was found to be increased in multiple sclerosis. The increase was caused by a decrease in erythrocyte deformability since plasma viscosity and haematocrit were normal. Plasminogen, fibrinogen and alpha 2 antitrypsin levels were found to be lower than normal. Such alterations were not observed in a group of patients with other non-immunological neurological diseases. In the latter group some coagulation indices were even higher than normal. The higher mean age of the pathological controls could explain the observed levels. The abnormalities observed in multiple sclerosis patients are considered to be a consequence of a non-specific activation of the coagulative system in a chronic immunological disease.

Adult↗

Hemorrhagic follicular cyst of the left ovary. An unusual complication of anticoagulant treatment.

A 34-year-old female, six months after surgery for implanting a mitral valve bioprosthesis (Hancock), was admitted to hospital because of acute abdomen. The patient had been on coumarin medication since the operation. On the 15th day of her menstrual cycle the patient presented gingival bleeding, epistaxis, and pain in the left lower abdominal quadrant. The prothrombin time was overdepressed (10% of normal), and coumarin drugs were stopped. Bleeding from the left ovary at time of ovulation was suspected and the patient was treated with vitamin K and then submitted to an exploratory laparotomy. A hemorrhagic cyst of the left ovary was found, and the histologic examination showed the cyst to be follicular in type.

Adult↗

Rheological and clotting changes in the immediate post-myocardial infarction period.

Several coagulative, fibrinolytic, and rheologic indices were studied in a large group of patients with acute myocardial infarction. The results were compared with those obtained in a normal control group. Changes of blood and plasma viscosity, fibrinogen, and fibrinolytic activity, compatible with a hypercoagulable state, were found in the immediate post-infarction period. However, elevated AT III levels as compared to control group were observed. This could be interpreted as a reactive response to the hypercoagulable state. Significant correlations could be observed between blood viscosity and Ht, plasma viscosity and fibrinogen, fibrinogen and fibrinolytic levels and between fibrinogen and ESR.

Adult↗

Evidence for the need of long-term antithrombotic therapy in patients with porcine heterograft heart valve.

The plasma levels of two platelet specific proteins, namely beta-thromboglobulin (beta TG) and platelet factor 4 (PT4), were investigated in 86 patients with different types of artificial valves, biological and disc, at different times after valve insertion. Significant differences were demonstrated for both proteins with increased age of the disc valve. On the other hand, no significant change in the high average levels was shown for patients with porcine heterograft (Hancock). The general view of anticoagulate or antiaggregate lasting only a few months after bioprosthesis insertion has to be carefully evaluated again.

Animals↗

In vitro and in vivo effects of ditazol on human platelets malonylaldehyde (MDA) production.

Ditazol (4,5-diphenyl-2 bis-hydroxyethylaminoxazol) was tested with regard to its effect in vivo and in vitro on platelet malonyladehyde (MDA) production which seems to be a good marker of prostaglandins metabolism. The drug is a powerful inhibitor of platelet MDA Production induced by thrombin in vitro and this action seems to be due to a "competitive" type effect. "In vivo" experiments showed a significant inhibitory effect on platelet MDA production 4--6 hours after administration of the drug, with return to basal levels within 24 hours.

Adult↗

Further studies on clotting changes in patients with cerebral sinus thrombosis. A case with thrombosis of right transverse sinus.

A 28 year old woman with angiographically proven thrombosis of right cerebral transverse sinus was studied from a clotting point of view. The changes noted were decreased fibrinolytic activity and increased collagen platelet aggregation. The patient presented loss of consciousness, aphasia, mental confusion, migh right hemiparesis, papilloedema. The treatment with dipyridamole, aspirin and a nicotinic acid derivative was followed by good results. After about a month the fundus reverted to normal. A clotting study is indicative in every patient with cerebral venous thrombosis.

Adult↗

Chromogenic substrate (S-2222) factor X assays in the follow-up of coumarin treated patients. No advantage over prothrombin time and/or thrombotest.

Factor X was assayed in 30 patients on long-term anticoagulation by means of a chromogenic substrate (S-2222) for a total of 120 determinations. The average level found was 25.38 +/- 9.38% of normal. A satisfactory correlation was found between the factor X chromogenic level and the prothrombin time or Thrombotest percental values. However, factor X levels as determined by the chromogenic assay were usually higher than the global tests percental figures. The factor X chromogenic level was also slightly higher than the RVV-cephalin factor X assay. Since the chromogenic assay does not allow any new information to be made on the coumarin induced defect and since the costs of the assay are about 20-30 times higher than those of a simple prothrombin time, the test seems to play no part in the follow-up of coumarin therapy.

Blood Coagulation Tests↗

Taipan viper venom and chromogenic substrate (chromozym Th). Prothrombin assay. No sensitivity to coumarin-induced prothrombin.

Prothrombin (factor II) was assayed in congenital or acquired prothrombin deficiencies and abnormalities using Taipan viper (Oxyuranus scutellatus) venom as activating agent and adsorbed normal plasma or a chromogenic compound (Chromozym-Th) as substrates. Prothrombin was found to be low, as expected in every instance, regardless of the substrate used. In coumarin treated patients the levels observed were similar to the prothrombin time percentile values and definitely lower than the immunological counterparts. Therefore, the Taipan viper venom appears suited for prothrombin assay even during anticoagulant therapy. Since the cost of the chromogenic substrate is about 20 times that of adsorbed normal plasma and since no special information is obtained by it, the use of the chromogenic method is not justified for routine purposes.

Blood Coagulation Disorders↗

Rheological and clotting changes in chronic cor pulmonale.

53 patients with chronic or pulmonale and hospitalized for the occurrence of acute dyspnea were studied. The mean age was 67. The increase in blood and plasma viscosities is higher than the rise in hematocrit, total plasma proteins and fibrinogen. The levels of plasminogen and antithrombin III are significantly lower and the plasma euglobulin lysis time is shortened. On the contrary, fibrinogen levels are normal or near normal. This seems to confirm the frequent presence of clotting changes in chronic cor pulmonale facilitated by an altered pulmonary rheology.

Adult↗

Improvement of platelet aggregation abnormalities in thrombocytosis after thrombocytopheresis.

Platelet function tests were performed in three patients with thrombocytosis in myeloproliferative disorders before and after a swift reduction of platelet count by thrombopheresis. The decrease of platelet count obtained after the procedure was reversed in six days. In two patients with platelet aggregation defects, the normalization of aggregation abnormalities was observed after pheresis, followed by a progressive decrease of platelet response until the pre-pheresis values on 6th day. In the third patient with normal platelet aggregation, a progressive increase of platelet aggregation response was noted on the days following thrombopheresis with ischaemic symptoms of a foot toe. In all three patients, the changes of platelet aggregation were accompanied by a related increase of megathrombocytes. In the two patients with platelet aggregation abnormalities, plasma and platelet beta-thromboglobulin levels were related to changes in platelet count and aggregation.

Adult↗

Trypsin clotting time (K-test) in hemophilia A and in hemophilia B1.

In investigations made in 32 patients with haemophilia A and 28 patients with haemophilia B the possibility of utilizing the trypsin clotting time (K-test) was tested in diagnosing both diseases. 23 plasmas of healthy test persons were used as controls and revealed a mean value of the K-test amounting to 24.52 +/- 0.75 seconds. With a mean value amounting to 30.025 +/- 2.88 seconds the K-test was clearly and from a statistical point of view significantly prolonged in hemophilia B contrary to hemophilia A with a slight prolongation amounting to 26.95 +/- 2.03 seconds. Possible causes for the response of the trypsin clotting tie are discussed.

Adolescent↗

An immunological study of prothrombin in liver cirrhosis.

Prothrombin was assayed in 24 patients with liver cirrhosis both as activity and as antigen. Prothrombin was found to be decreased by all methods and a good correlation was found among the three methods used. The serum prothrombin assay by means of the electroimmunoassay showed levels comparable to those observed in plasma, as expected. In the bidimensional electrophoresis system, plasma prothrombin appeared decreased but showed a normal mobility. Serum prothrombin in the same system showed the presence of three normal albeit reduced peaks or precipitates.

Antigens↗