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The authors report on using oil preparations in endoscopic surgery for arrest of bleedings from vessels of the stomach and duodenum. Persistent hemostasis was obtained in 60 out of 64 patients.
The study group on hemostasis and thrombosis calls the attention of the physicians to the fact that the Brussels community office has recommended the adoption of a new mode of expression of the results of the Quick time.
Eighty-seven patients with complicated patterns of peptic ulcer were examined for different components of the hemostatic system including gastric and duodenal fibrinolysis. It was established that the penetrating ulcer gives rise to hypocoagulemia and accelerates fibrinolysis. The perforating and hemorrhagic ulcers are associated with hypercoagulation, which is a manifestation of the stress response of the body. It is shown that gastric juice and the duodenal content have a hypocoagulation (heparinoid) action on blood and plasma coagulation. Peptic ulcer is marked by high gastric and duodenal fibrinolysis and proteolysis both in the gastric and duodenal mucosa and in the free gastric and duodenal contents as well. It is postulated that all the factors under consideration, which are unfavourable for local hemostasis, may be involved in the pathogenesis of gastroduodenal hemorrhages. The author holds that hemostatics, which suppress fibrinolysis and the acid-peptic factor and stimulate blood coagulation and clot formation in the zone of hemorrhage, may be used locally.
The effect of autotransfusions of blood irradiated by long-wave UV rays on the system of hemostasis was studied in 22 patients with ulcer disease of the stomach and duodenum. It was shown that transfusion of the autoblood irradiated by long-wave UV rays in a certain dosage decreased the hemostatic potential of blood improving its rheological properties and facilitated the stimulation of reparative processes.
The physiologic regulation of hemostasis is the result of several factors including antithrombin III as the most important one. Deficiencies of antithrombin III lead to an increased risk of thromboembolic diseases.
Microcirculation and hemocoagulation were examined in 88 patients with Sjögren's disease and Sjögren's syndrome (SD and SS) in 20 patients with chronic parenchymatous parotitis (CPP) without a "dry syndrome", and in 20 healthy donors by conjunctival angioscopy, capillaroscopy of the nail matrix, and histological study of the salivary glands. Hemostasis was explored with the use of 37 tests. SD and SS patients manifested significantly more pronounced microcirculatory disorders versus donors (P less than 0.001) and CPP patients (P less than 0.001). In patients with hypergammaglobulinemic purpura, microcirculatory disorders were found to be enhanced (P less than 0.05). An indirect relationship between these disorders and the degree of lacrimation lowering was established. Intravascular disturbances increased as the process activity rose and diminished under the effect of prednisolone therapy. It is assumed that microcirculatory and hemocoagulation disorders play an important role in the pathogenesis of SD and SS.
The hemostasis function was studied in 33 patients with epileptical seizures of a different etiology. The studies were conducted at the moment of the epileptical seizure or epileptical status and in the interattack period during hyperventilation. The concentration of products of blood fibrinogen degradation, the degree of platelet agregation, their number and prothrombine index were estimated. The data obtained were compared with those of normals. The results of the studies indicate the existence of the syndrome of intravascular coagulation during an epileptical seizure and epileptical status.
Uncontrolled bleeding at the recipient site is a complicating factor in hair transplant surgery. As a consequence, time consuming procedures as well as further discomfort for the patient is inevitable. In order to achieve adequate hemostasis, we present an easy method using cylindrical gelatin-plugs.
In view of setting new criteria of a thrombogenic risk, hemostasis was examined in 96 obesity patients and 30 control subjects. An increase in the fibrinogen level, inhibition of fibrinolytic activity, particularly of XIIa-kallikrein-dependent fibrinolysis were disclosed. No changes in the total blood coagulation activity were recorded. The fasting diet given to the patients for 18-20 days entailed a 12-15 kg weight reduction, fibrinogen level normalization, and fibrinolysis activation. Investigation of antithrombin activity in obesity patients' blood did not reveal any alterations.
Studies made in 30 patients with periodontosis have shown that thymaline improves the general health status of patients, thereby promoting the normalization of cellular and, to a lesser degree, humoral immunity. At the same time the drug normalizes blood coagulation, the total and Hageman factor-dependent fibrinolysis. It is concluded that thymaline is a modulator of the immunogenesis and hemostasis.
A case of bleeding cecal typhoid ulcer in a 22-year-old patient demonstrated by superior mesenteric arteriography is described. An attempt to stop hemorrhage using intraarterial vasopressin infusion, failed. However, arteriography proved helpful in locating the bleeding site, and in permitting conservative surgery, namely cecal ulcer suture to achieve hemostasis. On the basis of this case and a review of the literature, management of complicating hemorrhage resulting from typhoid fever is discussed, with particular reference to radiological procedures.
New antiaggregative and antianginal effects of an oral antiarrhythmic drug, lidocaine, are reported. Platelet hemostasis was investigated in 55 patients, with platelet function and morphology examined prior to and seven days after the onset of the lidocaine treatment. A significant decrease was noted in platelet aggregation with the dose of 2.5 (2.3-2.7) mg lidocaine per 1 kg of body weight taken four times daily at least. As the dosage increased, the drug antiaggregative properties were enhanced accordingly. Large doses, however, were associated with side-effects. The reported dose produced a nearly two-fold reduction in platelet aggregation rate, and anginal attacks were arrested in 80% of the patients, whereas platelet morphology was not affected.
Abnormalities of hemostasis in vivo and in vitro were defined in a prospective study of patients with typhoid fever. In a group of 56 patients with a proven diagnosis of typhoid fever, hemostatic abnormalities were frequently found. In patients with normal clotting tests the fibrinogen level was found to be higher than in normal controls. This finding established a new normal level for patients with typhoid fever. Using this redefined normal level it was found that low fibrinogen was associated with other hemostatic abnormalities. Low fibrinogen levels in patients with typhoid fever are possibly the result of disseminated intravascular coagulation. This process affected 20% of our patients and was often of mild to moderate intensity. Clinically significant bleeding occurred in 18 patients and, in contrast to the results of previously published studies, was found to correlate with clotting abnormalities.
Rabbits were exposed to carbon disulphide vapours in the toxicological chamber. Fibrinogen level, antiplasmin activity and soluble fibrin monomer complexes in the blood were increased, fibrinolysis time was prolonged. These disturbances in hemostasis depend on the concentration of carbon disulphide in the inhaled air and on the intoxication time. The authors suggest that these findings depend on the changed lipid metabolism and on the direct antagonistic influence of CS2 on coagulation and fibrynolysis agents.
Surgical treatment in patients with heavy coagulation disorders needs measures that minimize immediate and post-surgical hemorrhagic risk. Besides the subjects afflicted with constitutional coagulation pathologies such as haemophilia A, B, C, AB, Von Willebrand disease, platelet disorders and others, too many are the patients that need pharmacological therapy to impede the creation of intra-vascular coagula. Today, surgical treatment of these patients is possible with the use of human fibrin glue (Tissucol) that permits excellent surgical and post-surgical hemostasis without therapy suspension, independently of coagulation disorder. The purpose of this study is a clinical evaluation of a surgical procedure based on the use of human fibrin glue in association or not with suture, hemostatic sponge and lyophilized dura mater in patients with coagulation disorders. In a group of 309 patients in oral anticoagulant therapy have been done a total of 822 operations such as root fragments extraction with mucoperiosteal flap elevation, teeth or roots simple extractions, third molar extractions, cyst removal, apicoectomies. Only patients with PA over 20% have been treated. All the operations have been leaded with minimal trauma; after the extractions, alveolar margins have been regularized to improve flaps adaptation. Hemostatic sponge or dura mater have been used like basis for the flaps and the fibrin glue, that was injected in the residual cavity after surgical suture. In a few cases, for example with little extraction wounds, only fibrin flue without suture or sponge has been used. In all cases and after all operations, the presence or absence of bleeding has been evaluated after 2 hours, 24 hours, 7 days after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
As dental technology advances, clinicians are presented with a variety of new materials and application techniques for the restorative procedures. The learning objective of this article is to provide a sequential approach to the management of soft tissues and adhesive dentistry adjacent to the gingival tissues. Hemostasis and control of sulcular fluids are discussed as prerequisites for precise fitting and sealing of margins adjacent to gingival tissues. The utilization of a knitted displacement cord is introduced. The technique of applying hemostatic solution is presented for the clinician with a description of materials and application procedures.
Despite the use of H2-receptor antagonists for the prevention of stress lesions, 32 (9%) of the 354 wounded treated at the surgical intensive care units presented with upper gastrointestinal bleeding. 28 (87.5%) patients underwent endoscopic examination. The types of hemorrhage (capillary, venous and arterial bleeding) and the efficacy of hemostasis were analyzed. The bleeding ceased spontaneously in 17 (53.1%) patients, and 3 (9.4%) died in spite of all the endoscopic and surgical procedures undertaken.
The state of thrombocytic and coagulation hemostasis was studied on 89 patients, operated on for ulcerative disease with or without bleeding. The role of thrombohemorrhagic syndrome in the development of ulcerative bleeding, prethrombosis and predisposition to bleeding was determined. The changes of hemostasiogram without clinical manifestations point to the necessity of early treatment and prophylaxis measures.