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PubMed1990

Disseminated intravascular coagulation and bacterial infections in the elderly.

Anticoagulant screening tests (prothrombin time, thrombin time, kaolin-cephalin time and serum fibrinogen levels), platelet count and estimation of fibrinogen degradation products were carried out on 34 elderly patients with proven bacterial infections, 42 elderly patients with suspected bacterial infections and in 20 controls, to investigate the existence of a sub-clinical form of disseminated intravascular coagulation. The prothrombin time was significantly prolonged in bacterial infections of the elderly and subclinical intravascular coagulation was not found to be a feature. The screening tests did not show any correlation with the outcome of the disease or the presence of septicaemia.

Aged↗

PubMed1989

[Circulating anticoagulants in immunodeficiency virus infection. Results of a prospective study of 157 seropositive patients].

One hundred and fifty-seven HIV seropositive patients were included in a prospective study of coagulation parameters. Activated partial thromboplastin time, prothrombin time, thrombin time and specific factor assays of the intrinsic pathway were performed using standard techniques. The tissue thromboplastin inhibition test and antiphospholipid antibodies were used to establish the presence of circulating lupus anticoagulant. Among the 46 patients with a prolonged activated partial thromboplastin time, an anti-prothrombinase was present in 33. Of the 111 patients with a normal activated partial thromboplastin time, anti-prothrombinase was present in 51. Circulating lupus anticoagulant seems to be common in HIV seropositive patients, since it was found in 84 patients (53.5%). Our findings confirm that the presence of circulating anticoagulants is not particularly associated with opportunistic infections or the development of the disease. It is possible that these inhibitors could be mediated by anti-phospholipid antibodies. In HIV seropositive patients, defective T cell regulation of B cells leads to polyclonal hypergammaglobulinemia. These antibodies may be directed against endogenous or exogenous phospholipids.

Acquired Immunodeficiency Syndrome↗

PubMed1985

[ENT surgery and laboratory medicine--the modern aspects of cooperation].

The value and application of a multiphase screening programme of preoperative laboratory investigations on ENT patients is described and assessed. Appropriate laboratory investigation should be chosen. The methods of investigation should provide information about the patient's general condition, should identify disease which has escaped clinical assessment, which is not connected with the underlying disease, but which could severely handicap a patient undergoing surgery. They are also designed to assist in the medical screening of the general population. The programme includes tests of organ function and of metabolism. The frequency of abnormal laboratory values (less than 2.5% at to longer end of the normal distribution curve or above 5% at the other) was 7.8% for blood sugar, 2.9% for serum creatinine, 4.5% for urea, 11.6% for uric acid in men and 4.8% in women, 9.8% for serum cholesterol, 2.9% for SGOT in men and 20.8% for triglycerides. Tests included in the haemostasiological study were the basic coagulation testing programme (PTT, Prothrombin Time, Thrombin Time and Fibrinogen). Inherited and acquired blood disorders are detected through the full coagulation test programme and assay of the specific coagulation factors and fibrin degradation products. We diagnosed 11 inherited blood disorders in 10,000 patients put through the above screening programme. The problems of diagnosis and therapy of antibody haemophilia are demonstrated by an example of antibody haemophilia of factor VIII.

Blood Chemical Analysis↗

PubMed1985

[Hemostaseologic studies of maternal blood in intrauterine retardation and threatened premature labor].

Changes in coagulation of maternal blood in the case of severe gestosis, which indicated a relation to disturbed uteroplacental blood flow, gave rise to study other risk pregnancies and to do specific coagulation analyses. The following parameters were determined in 102 women showing a distinct tendency for premature labor, 20 women patients with suspicion of intrauterine growth retardation, and 18 normal pregnant women: Number of thrombocytes in whole venous blood, fibrinogen, plasminogen, reptilase time, thrombin time. Compared to the control group, a statistically significant increase in the number of thrombocytes was found only in the cohort of women showing signs of imminent premature labor during the 34th to 36th weeks of pregnancy. Both cohorts of patients showed markedly higher levels of plasminogen than the control group over the entire period of gestation studied in this investigation. All other parameters of coagulation showed no significant changes of pathological pregnancies in comparison with normal gravidas.

Adult↗

PubMed1979

Thrombus weight as a measure of hypercoagulability induced by drugs.

Thrombus weight was used as a measure of the thrombus enhancing effect of drugs in 135 rats. The weight of thrombus formed in one hour, on a 20 x 0.5 mm platinum wire, inserted in the vena cava was taken as a measure of thrombosis. The change in thrombus weight which followed the injection of ellagic acid to activate the coagulation system, adenosine diphosphate to activate the platelets, and epsilon-aminocaproic acid to inhibit the fibrinolytic system, was measured. Pilot studies showed that the drug doses used brought about the appropriate changes in the factors named. The mean thrombus weight in 45 control animals was 1.93 mg. Ellagic acid increased it about five-fold, and epsilon-aminocaproic acid almost two-fold, while adenosine diphosphate reduced it by almost a half. Concurrent controls were used in each case. Clotting tests (whole blood clotting time, kaolin-activated whole blood clotting time, thrombin time, and partial thromboplastin time), performed at the end of the hour, showed no significant correlation with thrombus weight.

Adenosine Diphosphate↗

PubMed1977

Soluble fibrin complexes in early fibrin digests.

Early fibrin digests were analyzed in the ultracentrifuge and were found to contain compounds with molecular weights up to 3 X 10(6); these compounds are considered to be soluble fibrin complexes. Their similarity with intermediate polymers in inhibited clotting systems has been stressed. Their viscosity at low shear rates is extremely high; therefore, a rapid method to establish their presence in plasma would be the measurement of plasma and serum viscosity at low shear rates, moreover, they shorten the clotting time (thrombin time) of fibrinogen considerably.

Animals↗

PubMed1978

Blood coagulation and fibrinolysis in haemorrhagic stroke.

Studies of 11 patients with haemorrhagic stroke revealed no significant change in kaolin cephalin clotting time, prothrombin time, thrombin time, PF 3 availability, platelet count and factor V and VIII during the first week. Plasma fibrinogen was significantly increased while factors VII + X were decreased (borderline significance). Prolongation of plasma recalcification time and decrease in heparin tolerance reached borderline significance. There was moderate, but significant, increase in serum antithrombin activity and plasma (euglobulin fraction) fibrinolytic activity.

Blood Coagulation↗

PubMed1984

Ranitidine and haemostasis in man.

The effect of ranitidine on the fibrinolytic activity and clotting factors was examined in 36 patients treated with ranitidine for gastric and duodenal ulcer in a randomized double-blind trial. Twenty patients were treated with ranitidine, and 16 received a placebo. The following determinations were made: euglobulin lysis time, coagulation time, prothrombin time, thrombin time, fibrinogen level and platelet count. It was found that therapeutic doses of ranitidine in patients with gastric and duodenal ulcer did not affect the relevant coagulation parameters.

Adult↗

PubMedDate not supplied

[Morphological composition and functions of the human blood coagulating and anticoagulating systems in prolonged exposure to low ammonia concentrations in a sealed environment].

A group of test subjects was kept in a chamber in which the ammonia concentrations 5.1 +/- 0.05 mg/m3 and 2.1 +/- 0.1 mg/m3 were maintained for 17 and 31 days, respectively; on days 22 and 38 the ammonia concentration was increased to 9.3 +/- 0.1 mg/m3. During this exposure, the morphological composition (red blood cells, hemoglobin, reticulocytes, platelets, white blood cells and their various types), as well as the coagulative-anticoagulative system (factor IV of platelets, index of blood clot retraction, recalcification time, thrombin time, ethanol and protamine sulphate paracoagulation tests, fibrinogen degradation products, fibrinolytic activity, fibrinogen and prothrombin content) were investigated. The parameters characterizing hemopoiesis and status of the coagulative-anticoagulative system did not show any significant changes. However, a slight decrease in the counts of leukocytes, neutrophils, eosinophils is of concern, because in space flight resistance to different infections declines.

Ammonia↗

PubMedDate not supplied

[Importance of disorders of primary hemostasis in the occurrence of upper digestive hemorrhage in cirrhosis].

In order to assess the true incidence of haemostatic disorders in cirrhotic gastro-intestinal haemorrhage, a comparative prospective study of primary haemostasis, coagulation and fibrinolysis was carried out in 37 patients distributed into two groups: cirrhotics with gastro-oesophageal varices that had never bled (Group A = 22), and cirrhotics who had had an intestinal bleed from "ruptured" gastro-oesophageal varices (Group B = 15). Combination of thrombocytopenia (less than 100 10(9)/l) and a bleeding time greater than 8 mn was more frequent in Group B (80%) than in Group A (45%) (p = less than 0.05). On the other hand, no significant difference between the two groups was found in the activated cephalin time, thrombin time, prothrombin complex factors (II, V, VII-X), fibrinogen, antithrombin III, Factor VIII complex factors, FDP levels or plasminogen. In conclusion, these results suggest that disorders of primary haemostasis may be involved in bleeding from gastro-intestinal varices in cirrhosis. However, coagulation disorders and anomalies of fibrinolysis would not seem to play a determining role.

Bleeding Time↗

PubMed1984

[Changes in the blood coagulating properties of preserved blood and the native and lyophilized plasma of cattle during storage].

Studied were some of the indices characterizing the blood clotting system (thrombocytes, fibrinogen, recalcified clotting time, CA-thromboplastin time, kephalin-kaolin time, thrombin time. F II, and F V) in preserved glucose-citrate blood kept at 4 degrees C, in untreated bovine plasma kept at 20 degrees C, 4 degrees C, and -20 degrees C, and in freeze-dried bovine plasma. It was concluded that bovine blood preserved with L-12 could be used as a hemostatic agent up to the 10th day after it was obtained; untreated plasma could be used up to one month after it was obtained; and freeze-dried plasma could be used up to two months after it was obtained. Following freeze-drying the coagulation properties of the plasma remained active for more than a year, and it could also be used as a hemostatic agent.

Animals↗

PubMed1984

[Pharmacological studies of FUT-175, nafamstat mesilate. IV. Effects on coagulation, platelets and fibrinolysis].

Inhibitory effects of FUT-175 (nafamstat mesilate) on coagulation, platelets and fibrinolysis were examined. FUT-175 prolonged activated partial thromboplastin time, thrombin time and prothrombin time in rabbit plasma. FUT-175 prolonged these coagulation times in human plasma at lower concentration than in rabbit plasma. FUT-175 inhibited platelet aggregation induced by a variety of aggregation agents in rabbit platelet-rich plasma (PRP). In human PRP, FUT-175 inhibited platelet aggregation induced by a variety of aggregation agents at lower concentration than in rabbit PRP. Lipopolysaccharide induced a dose-dependent platelet aggregation in dog PRP. FUT-175 showed an inhibitory effect on this aggregation. FUT-175 inhibited clot retraction in rabbit plasma. The fibrinolysis activity was measured on fibrinolysis of rabbit plasma activated by urokinase. FUT-175 prolonged this fibrinolysis time. Inhibitory effects on coagulation and fibrinolysis were also found ex vivo. FUT-175 prolonged bleeding time in mice. These results indicate that FUT-175 has potent inhibitory effects on coagulation, platelets and fibrinolysis.

Animals↗

PubMed1994

Acute effects of intravascular absorption of 32% dextran 70 on blood coagulation, electrolytes and arterial blood gas.

Thirty-two percent dextran 70 is used to help visualize the uterine cavity during hysteroscopy and is also used intraperitoneally to prevent adhesions. We measured serum electrolytes, serum osmolarity, hematocrit, arterial blood gas and coagulation profile in 11 patients receiving dextran 70 while undergoing hysteroscopy. Dextran 70 had no significant effect on prothrombin time, partial thromboplastin time, thrombin time, fibrinogen level or serum osmolarity. There was a significant decrease in hematocrit, serum sodium and oxygen tension of arterial blood (PaO2). The decrease in sodium and hematocrit suggested hemodilution. This study demonstrated that 32% dextran 70 had a minimal effect on the majority of laboratory parameters measured.

Absorption↗

PubMed1993

[Therapy of disseminated intravascular coagulation in acute promyelocytic leukemias. Apropos of 19 cases].

PURPOSE: To evaluate our experience in the treatment of disseminated intravascular coagulation (DIC) associated to AML-M3 with substitution therapy with or without heparin. PATIENTS AND METHODS: The clinical records of 19 patients diagnosed of AML-M3 in the Hospital Juan Canalejo, in La Coruña, between 1986 and 1991 were revised. DIC was defined by abnormalities in one or more of the following: prothrombin time, activated partial thromboplastic time, thrombin time, fibrinogenaemia, fibrin/fibrinogen degradation products, D-dimers. The treatment given to 13 patients was only substitutive including platelets, fresh-frozen plasma, cryoprecipitates and antithrombin III. Low-dose sodium heparin (Kabi) in continuous intravenous infusion was associated to the treatment of the remaining 6 patients. With regard to the leukaemic therapy, most of the patients received daunorubicin, 2 mg/kg/day x 5 days, and AraC, 100 mg/Kg/day x 7 days. RESULTS: All patients showed haemorrhagic symptoms at diagnosis, and laboratory data of DIC were present in 11 cases (57%). The mean duration of DIC was 6.5 days for the patients receiving substitutive treatment and 9.5 days for those given heparin. Complete remission (CR) of the leukaemia was attained in 12 cases (63%); of the patients treated with heparin, 50% achieved CR whereas 75% of those receiving substitute therapy attained CR. The 24-months survival rate was 30% for the patients treated with substitutive therapy and 16% for those treated with heparin. The incidence of death associated to haemorrhage during induction therapy was 30% for the substitutive treatment group and 50% for the heparin group. CONCLUSION: Shorter duration of DIC, lesser rate of early death, higher CR rate and longer 2-year survival were found in those AML-M3 patients not receiving heparin.

Adolescent↗

PubMedDate not supplied

[Variations in hemostasis and fibrinolysis during the treatment of acute myocardial infarct (AMI) with tissue-type plasminogen activator (TTPA). A study of 17 cases].

The aim of this trial was to estimate changes in the coagulation and fibrinolysis systems during the thrombolytic treatment with recombinant human tissue-type plasminogen activator (rt-PA) in patients with acute myocardial infarction and correlate with hemorrhagic complications. We studied 17 patients with a 3 hours-continuous systemic infusion of 100 mg of rt-PA. Prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen splits products, plasminogen, alfa-2-antiplasmin (a-2AP) and antithrombin III (AT-III) were performed before, during and after infusion. Most patients showed lengthening coagulation times. Fibrinogen and plasminogen were decreased and PDF was increased. No variations in alpha-2AP or AT-III were observed. The recuperation of fibrinogen levels occurred in 3 hours and there was hyperfibrinogenemia after day 3. No hemorrhagic complication was observed in patients with abnormalities in these coagulation or fibrinolytic tests.

Adult↗

PubMed1977

The relationship of coagulation factors to clinical complications of acute pancreatitis.

Alterations in coagulation factors have been reported during acute pancreatitis. Therefore the relationship of coagulation measurements to complications of pancreatitis was evaluated prospectively in 35 patients in whom 130 serial coagulation profiles were performed, consisting of fibrinogen, platelet count (PC), fibrinogen-fibrin-related-antigen (FR-antigen), prothrombin time (PT), partial thromboplastin time, thrombin time, euglobulin clot lysis, and Factors II, V and VII-X levels. During attacks of acute pancreatitis, over-all mean initial fibrinogen and PC of 268 mg. per 100 ml. and 214,000 per cubic millimiter rose significantly (p less than 0.005) to peaks of 362 mg. per 100 ml. and 477,800 per cubic millimeter by day 6 to 10. Mean initial FR-antigen of 4.8 microgram per milliliter rose to peak 7.4 microgram per milliliter on day 5. In 21 patients with mild pancreatitis, mean highest fibrinogen, PC, FR-antigen, and PT were 329 mg. per 100 ml., 361,500 per cubic millimeter, 5.3 microng per milliliter and 14.1 seconds. These values were significantly higher (p less than 0.05 to 0.01) in patients with severe pancreatitis, being 422 mg. per 100 ml. 528,000 per cubic millimeter, 13.7 microng per milliliter, and 15.5 seconds, respectively. Evaluation of the relationship of coagulation measurements to early clinical features showd that mean initial fibrinogen levels were significantly higher (p less than 0.05 to 0.01) in patients with initial amylase greater than 1,000 Somogyi units percent, serum glutamic oxaloacetic transaminase (SGOT) greater than 250 S.F.U. percent, and initial 72 hour PAO2 less than 75 mm. Hg. Early hypoxemia also correlated (p less than 0.05) with elevated initial FR-antigen levels. Impaired early renal function correlated (p less than 0.01) with elevated initial PC only. Early hypocalcemia did not correlate with coagulation measurements. These findings demonstrate that marked changes in coagulation parameters occur during acute pancreatitis and are related to over-all morbidity. Correlation of early coagulation measurements with amylase levels and with respiratory, renal, and hepatic dysfunction suggests that enzyme-related intravascular coagulation may be implicated in the pathogenesis of these complications of pancreatitis.

Acute Disease↗

PubMed1995

Short-time rabbit model of endotoxin-induced hypercoagulability.

We describe a short-time endotoxin-induced rabbit model of hypercoagulability for the study of the coagulation cascade and the therapeutic effects of coagulation inhibitors. Cardiorespiratory function was maintained in rabbits under general anesthesia and standardized mechanical ventilation (tidal volume, 6 ml/kg; 60 breaths/min) via tracheostomy and low-dose inotropic support. Coagulation parameters such as prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen concentration, platelet count, fibrin monomers, D-dimers, antithrombin III and factor XIII activities, thrombelastography, and platelet aggregometry were measured during a 4-h period after sequential double endotoxin administration (80 and 40 micrograms/kg of body weight, intravenously). Mean arterial pressure and arterial and central venous blood gas tensions were monitored. Global clotting, activation parameters of coagulation, and leukocyte count deteriorated significantly in the endotoxin-treated animals but was mainly unaltered in controls (P < 0.05). Tissue specimens of the lungs, liver, brain, and kidneys were examined. Endotoxin-induced, disseminated fibrin deposition was found in the lungs and liver (P < 0.01). We conclude that this short-time model of hypercoagulability in rabbits reliably induced disseminated intravascular coagulation. Tracheostomy and mechanical ventilation provided a reproducible model in which the differences between the controls and the endotoxin-treated animals were exclusively due to administration of endotoxin and not to unforeseen complications of the respiratory system. This model allows the study of therapeutic effects of coagulation inhibitors on endotoxin-induced changes.

Animals↗

PubMed1996

[Basic values of blood coagulation parameters in pigs (Sus scrofa domesticus)].

On 23 clinical healthy pigs (2-4 months of age, body weight 13-42 kg) under ketamin-pentobarbital anaesthesia blood plasma coagulation parameters have been investigated. To obtain basic values 26 parameters were measured: number of thrombocytes, parameters of thrombelastogram and resonance-thrombogram, prothrombin time, activated partial thromboplastin time, thrombin time, reptilase time, factors I, II, V, VII, VIII, X, antithrombin III, plasminogen, alpha 1-antitrypsin, alpha 2-antiplasmin, alpha 2-macroglobulin, fibrin degradation products D and E and euglobulin lysis-time. Parameters calculated in percent should be measured against a pig plasma pool. Measurement against a human plasma pool are hardly valid in values higher than 100%. In comparison to man the results indicate modifications of fibrinogenesis and fibrinolysis in pigs.

Animals↗