Current Issue : April - June Volume : 2017 Issue Number : 2 Articles : 7 Articles
Background: The risk of spinal haematoma in patients receiving epidural catheters is estimated using routine\ncoagulation tests, but guidelines are inconsistent in their recommendations on what to do when results indicate\nslight hypocoagulation. Postoperative patients are prone to thrombosis, and thromboelastometry has previously\nshown hypercoagulation in this setting. We aimed to better understand perioperative haemostasis by comparing\nresults from routine and advanced tests, hypothesizing that patients undergoing major upper gastrointestinal\nsurgery would be deficient in vitamin K-dependent coagulation factors because of malnutrition, or hypocoagulative\nbecause of accumulation of low molecular weight heparin (LMWH).\nMethods: Thirty-eight patients receiving epidural analgesia for major upper gastrointestinal surgery were\nincluded. We took blood at the time of preoperative epidural catheterization and at catheter withdrawal.\nProthrombin time-international normalized ratio (PT-INR), activated partial thromboplastin time (aPTT) and\nplatelet count (Plc) were analysed, and also albumin, proteins induced by vitamin K absence (PIVKA-II),\nrotational thromboelastometry (ROTEMÃ?®), multiple electrode aggregometry (MultiplateÃ?®) and activities of\nfactors II, VII, IX, X, XI, XII and XIII.\nResults: Postoperative coagulation was characterized by thrombocytosis and hyperfibrinogenaemia. Mean PT-INR\nincreased significantly from 1.0 Ã?± 0.1 to 1.2 Ã?± 0.2 and mean aPTT increased significantly from 27 Ã?± 3 to 30 Ã?± 4 s. Activity\nof vitamin K-dependent factors did not decrease significantly: FIX and FX activity increased. FXII and FXIII decreased\nsignificantly. Mean Plc increased from 213 Ã?± 153 Ã?â?? 106/L while all mean ROTEM-MCFs (maximal clot firmnesses)\nespecially FIBTEM-MCF increased significantly to above the reference interval. All mean ROTEMÃ?® clotting times were\nwithin their reference intervals both before and after surgery. ROTEMÃ?® (HEPTEM minus INTEM) results were spread\naround 0. There were significant correlations between routine tests and the expected coagulation factors, but not any\nof the viscoelastic parameters or PIVKA-II. MultiplateÃ?® area under curve and EXTEM-MCF correlated significantly to Plc\nas did EXTEM-MCF to fibrinogen, FIX, FX and FXIII; and FIBTEM-MCF to Plc, FII, FXI and FXIII. Conclusions: The increase in PT-INR may be caused by decreased postoperative FVII while the elevated aPTT may be\ncaused by low FXII. The mild postoperative hypocoagulation indicated by routine tests is not consistent with\nthromboelastometry. The relevance of ROTEMÃ?® and MultiplateÃ?® in the context of moderately increased routine tests\nremains unclear....
Foods uptakes and Body Mass Index BMI of healthy young and old men were measured by self-administered questionnaires. Blood samples were taken at fasting times and levels of various plasma parameters were measured. There were no correlations between sucrose and sweet beverage uptakes and BMI or fasting blood glucose levels. No correlations were found between sucrose and sweet beverage uptakes and TG (triglycerides) or Low density lipoprotein (LDL)-cholesterol levels. Total amino acids, total non-essential amino acids, and total essential amino acids levels decreased in young men, who took more sucrose and sweet beverage. BMI significantly increased in young and old men whose insulin levels were high. There were no correlations between BMI or plasma parameters and the amount of energy, protein, lipid or carbohydrate uptakes. These results may suggest that in healthy non-obese young and old men sucrose and sweet beverage uptakes are not related to increase in BMI and any particular kind of food uptake is not related to increase in BMI....
Alcohol is a known modulator of the innate immune system. Owing to the absence of human studies, alcohol�s effect on circulating\ncytokine profile remains unclear. We investigated the effect of acute high dose alcohol consumption on systemic cytokine release.\nAfter an overnight fasting, alcohol-experienced healthy male volunteers (...
Background: About 2ââ?¬â??3 % of the population participates in blood donation programmes. Each whole blood donation\nor ten apheresis donations cause a loss of 200ââ?¬â??250 mg of iron. As a result, one of the most common risks of regular\nblood donors is iron deficiency. Although this has been known for decades, in most countries, iron status is currently not\nassessed or treated in this population. Premenopausal women are particularly affected, as they have lower iron reserves\nand higher daily requirements. Besides anaemia, iron deficiency may lead to fatigue and impaired cognitive and physical\nperformance. Current iron preparations for intravenous administration are well tolerated and allow for application of large\ndoses up to 1 g in one visit. Our hypothesis is that in blood donors with iron deficiency, intravenously administered iron\nis more efficient and as safe as oral iron supplementation. Since anaemia is one of the most frequent reasons for\npermanent or intermittent donor deferral, maintaining an iron-replete donor pool may help to prevent shortages in\nblood supply and to avoid iron deficiency-related comorbidities.\nMethods/design: In this randomised clinical trial we include male and female blood donors aged ââ?°Â¥18 and ââ?°Â¤65 years\nwith a ferritin value of ââ?°Â¤30 ng/ml. Stratified by gender, participants are randomized with a web-based randomisation tool\nin a 1:1 ratio to either 1 g of intravenously administered ferric carboxymaltose or 10 g of iron fumarate supplements at\none to two daily doses of 100 mg each. Eight to 12 weeks after the first visit, iron status, blood count and symptoms are\nassessed in both groups. The primary endpoint is the difference in transferrin saturation (%) following the intervention\nbetween both groups. Secondary endpoints include other parameters of iron metabolism and red blood cell count, the\nnumber of patients with drug-related adverse events, and subjective symptoms including those of the restless legs\nsyndrome, quality of life, and fatigue.\nDiscussion: Iron supplementation administered intravenously in non-anaemic but iron-deficient blood donors\ncould represent an effective strategy to protect blood donors from comorbidities related with iron deficiency\nand therefore improve blood donor wellbeing. Furthermore, iron supplementation will help to maintain an\niron-replete blood donor pool....
Background: Epidermolysis bullosa (EB) belongs to a family of rare heterogeneous, genetic disorders characterized\nby blistering of the skin and mucous membranes in response to minor mechanical trauma. The involvement of the\noral mucosa and oesophagus stenosis is suggested to be responsible for severe nutritional deficiencies, but few\nstudies have till now considered this aspect. This observational study aimed to evaluate homocysteine status in\nchildren and adolescents with EB by assessing total plasma homocysteine (tHcy) and metabolically related vitamins\n(B6, B12, folate) concentrations.\nMethods: Twenty EB patients (12 M; age range 0.5âË?â??19 years) were evaluated for: plasma tHcy, serum B12 and\nholotranscobalamin (HoloTC, the active fraction of B12), serum and erythrocyte folate (s-F and Ery-F, respectively),\nplasma B6 and serum high sensitive C-reactive-protein (hsCRP) levels. Clinical severity was also evaluated through\nthe Birmingham Epidermolysis Bullosa Severity (BEBS) score. A sex and age well-matched population was also\nenrolled.\nResults: EB patients showed tHcy levels higher (p = 0.04) and B6 levels lower (p = 0.03) than controls. B12, HoloTC, s-F\nand ery-F concentrations did not differ between patients and controls. Multiple linear regression analysis showed that\ntHcy levels were independent of the metabolically related vitamins levels. In addition, serum hsCRP levels were higher\nin EB patients than in controls (p = 0.003) and correlated negatively with B6 concentrations (r = -0.6; p = 0.009). BEBS\nscore correlated negatively with HoloTC (p = 0.022) and B6 (p = 0.005) levels and positively with age (p = 0.031) and\nhsCRP levels (p < 0.001).\nConclusions: The assessment of tHcy and metabolically related vitamin levels describes an important aspect of EB\npatientsââ?¬â?¢ nutritional status which can result essential for their long term care. Monitoring B6 levels in EB patients could\nbe particularly important in order to prevent several complications associated with B6 deficiency and to avoid a B6\nexcess which sustains an inflammatory condition....
Background: Steroid resistant (SR) asthma is characterized by persistent airway inflammation that fails to resolve\ndespite treatment with high doses of corticosteroids. Furthermore, SR patient airways show increased numbers\nneutrophils, which are less responsive to glucocorticoid. The present study seeks to determine whether\ndexamethasone (DEX) has different effect on neutrophils from steroid sensitive (SS) asthmatics compared\nto SR asthmatics.\nMethods: Adults with asthma (n = 38) were classified as SR or SS based on changes in lung FEV1% following\na one-month inhaled corticosteroid (ICS) treatment. Blood samples were collected from all patients during their\nfirst visit of the study. Neutrophils isolated from the blood were cultured with dexamethasone and/or atopic\nasthmatic serum for 18 h. The mRNA expression of mitogen-activated protein kinase phosphatase-1 (MKP-1),\na glucocorticoid transactivation target, and glucocorticoid-induced transcript 1 (GLCCI1), an early marker of\nglucocorticoid-induced apoptosis whose expression was associated with the response to inhaled glucocorticoids\nin asthma , was determined by real-time PCR, and ELISA was used to assess the pro-inflammatory cytokine IL-8\nlevels in the supernatant. Constitutive neutrophil apoptosis was detected by flow cytometry.\nResults: DEX significantly induced MKP-1 expression in both patients with SS and SR patients in a concentrationdependent\nmanner, but greater induction was observed for SS patients at a low concentration (10âË?â??6 M).\nAsthmatic serum alone showed no MKP-1expression, and there was impaired induction of MKP-1 by DEX in SR\nasthma patients. The expression of GLCCI1 was not induced in neutrophils with DEX or DEX/atopic asthmatic\nserum combination. Greater inhibition of IL-8 production was observed in neutrophils from patients with SS\nasthma treated with DEX/atopic asthmatic serum combination compared with SR asthma patients, though DEX\nalone showed the same effect on neutrophils from SS and SR asthma patients. Meanwhile, DEX dependent\ninhibition of constitutive neutrophil apoptosis was similar between SS asthma and SR asthma patients.\nConclusions: DEX exerted different effects on neutrophils from patients with SS asthma and SR asthma, which\nmay contribute to glucocorticoid insensitivity....
Background: The present study aimed to investigate the infections of Polyomaviruses JCV (John Cunningham\nvirus) in renal transplant recipients in Khartoum State in Sudan and to compare the results of the detection of JCV in\nurine and plasma.\nMethodology: A total of 50 Plasma and 50 urine samples were collected randomly from renal transplant recipients\nattending Sudanese Renal Transplant society during period between January and February 2016. The samples were\nsubjected to polymerase chain reaction (PCR) assay to detect the viral deoxyribonucleic acid (DNA).\nResults: Among the 50 renal transplant patients the Polyomaviruses nucleic acid was detected in 24 plasma\nspecimens (48%) and only in 14 urine specimens (28%) by using conventional PCR method.\nConclusion: JC Virus is related to clinical manifestations among renal transplant patients. The routine use of\nPCR on urine and plasma is a useful tool for the rapid and sensitive detection of JC virus in renal transplant recipient....
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