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[A method for the luminescence microscopy of the thrombocytes in the diagnosis of hemostatic disorders in patients with cerebral atherosclerosis].

The authors evaluated the diagnostic importance of morphological properties of thrombocytes in patients with cerebral atherosclerosis. The proposed method consists in vital staining of thrombocytes in the blood plasma by means of acridine arrange, their fixation, application of a smear, microscopy in ultraviolet rays with determination of the ratio of thrombocytes of separate classes according to the intensity of luminescence of cellular alpha-granules and presence of aggregates. The method may be used for the prognosis of thrombotic complications in patients with atherosclerotic dyscirculatory encephalopathy and controlling the efficacy of therapy by antiaggregant agents.

Adult↗

[Antithrombotic therapy in correcting hemostatic disorders in patients with chronic glomerulonephritis].

The effect of heparine and streptokinase on the indices of hemostasis and fibrinolysis was studied in 74 patients with different clinical variants of chronic glomerulonephritis. Differences were shown in changes of hemocoagulation and fibrinolytic potentials of the blood depending both on the nature of the employed medicinal agent and on the initial level of blood coagulation and fibrinolysis.

Adolescent↗

[Characteristics of hemostatic disorders in septic shock in children].

Changes at different stages of coagulation cascade have been assessed during intensive therapy of septic shock in 40 children aged 1 to 14 years. Progressing septic shock is accompanied by chronometric and structural hypocoagulation with potential hypercoagulation in transfer samples, thrombocytopenia and thrombocytopathy. Terminal stages of septic shock are characterized by profound hypocoagulation without potential hypercoagulation, predominance of antithrombin and antiaggregant blood activity with persistent depletion of antithrombin III and plasminogen. The decrement of arterio-venous difference in hemostasis parameters is typical of marked stages of the shock lung. Dynamic control over hemostasis shifts makes it possible to predict the outcome of septic shock.

Adolescent↗

[Evaluation of specialist instructions at a hospital center based on compliance. A study of 47 patients with mild hemostatic disorders].

Individual with so-called mild bleeding disorders (MBD) are being investigated with increasing frequency on an outpatient basis at the Central Hematology Laboratory of the Inselspital, Berne. Following diagnosis of a given disorder the patients are informed orally, and sometimes also in writing, concerning the nature of the disorder, prophylactic and therapeutic measures prior to elective surgery, and the role of certain drugs in promoting hemorrhage. In the present study we attempt to evaluate the quality of these specialized medical services catamnestically. As a first step 67 patients with well defined bleeding disorders, and who had had no further contact with this institution since the investigation, were invited for interview. The interviewer was unknown to the patients and the patients participating in the study remained anonymous. A total of 47 patients came for interview. The goal of the enquiry was to find out how far the advice given by the physicians of our laboratory had been actually taken, or what were the possible grounds for ignoring it. Since MBD causes few symptoms in everyday life and complications may arise only as a consequence of surgery, there were particular problems in properly informing patients and thereby motivating them to act on medical advice. On the basis of the criteria selected, two thirds of patients showed adequate, and one third inadequate, compliance. Compliant patients correlated significantly with understanding of diagnosis, carrying brief written information with them for emergencies, coping with disease in general, poor perception of their own body, a "positive memory for medical advice", and their position within the family.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Coagulation Disorders↗

[Microcirculatory and hemostatic disorders in calculous pyelonephritis patients].

The state of microcirculation and the system of hemostasis were studied over time in 52 patients with chronic calculous pyelonephritis. Investigations were performed before operation, after 2-4 days, 5-7 days and on discharge. The patients were divided into 2 groups: with chronic pyelonephritis in the phase of active inflammation and with chronic pyelonephritis in the phase of remission. Marked disorders in the system of hemostasis characterized by hyperfibrinogenemia, thrombinemia, a decrease in the heparincofactor plasma activity, activation of platelet hemostasis, a decrease in CPa-dependent fibrinolysis were noted in the patients with calculous pyelonephritis in the phase of active inflammation. These shifts were combined with disorders in the microcirculatory system: intermittent blood flow and disseminated erythrocyte aggregation, a prolonged period of nuclide half-life in the intracutaneous depot. In the patients with calculous pyelonephritis in the remission phase shifts in the system of hemostasis were less noticeable, microcirculatory disorders were undetectable.

Adult↗

[Primary hemostatic disorders caused by beta-lactams. Apropos of a postoperative hemorrhagic complication during treatment with cephalexin].

The authors report a case of haemorrhage due to cephalexin therapy. The bleeding started after an orthopedic operation in a patient without renal failure, receiving 3 g/day of cephalexin. Platelet function was very abnormal at the time of the haemorrhage with a bleeding time of over 20 minutes, which returned to normal when treatment was stopped. This case seems to be similar to other reports of haemorrhages during treatment with other beta-lactams.

Aged↗