[Blood coagulation monitoring in oral anticoagulant therapy using chromogenic substances].
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4-Hydroxycoumarins↗
Biomedical subjects
G Pindur
Publications and source records attributed to G Pindur.
Influence of HIV-infection on the Karnofsky score and general social functioning in patients with hemophilia.
Quality of live, defined by different models, has become a major focus of research in chronic disorders. Patients with hemophilia have been found to suffer seriously from the impact of HIV infection. To compare the impact of HIV infection on HIV-positive and HIV-negative patients, we evaluated a group of 60 patients, 30 being positive and 30 negative, suffering from hemophilia, using the Karnofsky index of functioning besides more general social and clinical data. Most patients (n = 53) suffered from hemophilia A. The mean Karnofsky score decreased from 65.22 to 63.43 in the HIV-infected group between 1988 and 1991, but increased from 77.7 to 82.2 in the HIV-negative group; differences were not significant, though differences were significant between the HIV-infected and HIV-negative groups. The Karnofsky score remained constant or increased in 26 (86.6%) of the HIV-negative patients, in contrast to 50% in the infected group. Seven patients, all from the infected group, had died in 1991. The initial Karnofsky score was not a prognosticator of survival. The group as a whole was socially well integrated. Consequently, the Karnofsky score can be a useful instrument in evaluating the global quality of live in HIV-infected patients, though a careful evaluation of results is necessary and a low initial score does not predict survival.
Adolescent↗
Effect of an ionic compared to a non-ionic X-ray contrast agent on platelets and coagulation during diagnostic cardiac catheterisation.
The aim of the present study was to evaluate the effects of ionic (ioxaglate) and non-ionic (iopromide) contrast media on haemostatic parameters ex vivo. In 40 patients undergoing coronary angiography, platelet function (platelet reactivity and serotonin concentration) and coagulation markers [thrombin-antithrombin III complexes, prothrombin fragments (F1+2) and the D-dimers] were measured. The use of an ionic X-ray contrast agent (XCA) (ioxaglate) in diagnostic cardiac catheterisation angiography is associated with lower thrombin generation and lower activation of the platelet system than when a non-ionic XCA is employed (iopromide). The results thus confirm the results of various in vitro studies and animal investigations.
Aged↗
Highly substituted hydroxyethyl starch (HES200/0.62) leads to Type-I von Willebrand syndrome after repeated administration.
Hydroxyethyl starch (HES) is a frequently used plasma substitute that is popular due to a high degree of therapeutic safety. However, the administration of large volumes of highly substituted, high-molecular-weight starch often leads to iatrogenic von Willebrand syndrome (vWS) with hemorrhagic complications. In patients with cerebral circulatory disturbances we carried out hemodilution therapy during 9-10 days, infusing HES 200/0.62. A von Willebrand factor (vWF) multimeric analysis was carried out in 6 patients using a modified western blot according to the sodium dodecyl sulfate agarose gel electrophoresis method. The vWF multimeric analysis showed that all multimers decreased to the same degree, corresponding to type-I vWS.
Aged↗
Influence of low molecular weight hydroxyethyl starch (HES 40/0.5-0.55) on hemostasis and hemorheology.
Hydroxyethyl starch (HES) with a high or medium molecular weight (MW) and a high degree of substitution is difficult to degrade and leads to an accumulation of large molecules. These molecules have a negative effect on hemostasiological parameters. In 10 patients with cerebrovascular diseases, a hemodilution therapy was carried out with low MW HES for 10 days. Due to the low MW of the HES used (56-61 kD), the rheological parameters erythrocyte aggregation and plasma viscosity were significantly lowered (p < 0.01). No coagulation parameters studied were affected beyond the dilution effect, which was measured using the decline in hematocrit. Low MW starch is a volume substitute that is well-suited for repeated infusion or hemodilution therapy, particularly for patients with increased hemorrhagic diathesis, because it does not affect hemostasis. The disadvantage of a relatively short volume effect can be compensated through a continuous infusion of a larger volume.
Aged↗
Haemostatical and rheological aspects of dysfibrinogenemia.
Congenital dysfibrinogenemia is based on different alterations in the structure of the fibrinogen molecule leading to a variety of disturbances in the clotting process. Clinical manifestations of the disorder are showing a wide range from asymptomatic states to mild bleeding diathesis as well as thrombotic complications. In this study two of the 14 patients with dysfibrinogenemia showed a history of mild bleeding while the others showed no clinical symptoms. As fibrinogen is also an important factor of the blood fluidity not only haemostatic but also rheological parameters were measured. Included in the study were 14 patients with ascertained dysfibrinogenemia in comparison to 11 non-affected relatives and a control group of 297 apparently healthy subjects. Plasma viscosity (p < 0.0001) and erythrocyte aggregation index (p < 0.00001) were significantly higher in the patients than in their healthy relatives and the control group. A pathologically increased erythrocyte aggregation was found in 10 of the 14 patients but only in 1 of the 10 relatives. The dysfunction of the fibrinogen molecule thus influences the aggregation process of the red blood cells to a greater extent than normal fibrinogen. Moreover, there seems to be a stronger influence of the dysfunctional fibrinogen molecule on the aggregation process than on plasma viscosity. To date the question if the enhanced erythrocyte aggregation in dysfibrinogenemic patients may be of any diagnostic interest and if there are significant differences between patients with bleeding diathesis and thrombophilia cannot be answered and remains to be cleared in further investigations.
Analysis of Variance↗