Anti-clotting Agents Research Articles

Review on clinical strategies for managing patients with elevated Lp(a): Cost-effectiveness of Lp(a) testing and awareness of lifestyle changes via Public Health Policy in absence of targeted therapy

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Novartis Pharma AG, Basel, Switzerland Introduction Elevated lipoprotein(a) [Lp(a)] is an inherited, independent, and causal risk factor for atherosclerotic cardiovascular disease (ASCVD). Approximately, 20%-30% of global population has elevated Lp(a), however, Lp(a) measurement is not performed routinely in clinical practice. Purpose This review aimed to identify treatment patterns for patients with elevated Lp(a). In addition, a cost-effectiveness analysis (CEA) was performed to hypothesize that in the absence of Lp(a)-targeting therapy, broader Lp(a) testing, awareness of its additional risk and assertive management of other CV risk factors (e.g., LDL levels, BMI, Pulse pressure), may clinically and economically benefit patients and the healthcare system. Methods A systematic literature review was conducted using Embase®, MEDLINE® and MEDLINE®-In Process databases to identify the existing approaches for managing patients with ASCVD having elevated Lp(a). In addition, using a decision tree economic model and predictive risk equations from UK Biobank data, the cost effectiveness of Lp(a) screening and public policy awareness impact on other CV risk factors via lifestyle changes (e.g., diet, exercise, smoking) was assessed from a healthcare system perspective. Results Out of 6,387 retrieved publications, 45 studies were included. An average of 72%, 72%, 48% and 22% patients received lipid lowering therapies (LLTs), anti-clotting agents, anti-hypertensives and anti-diabetics, respectively. In the absence of Lp(a)-targeting therapy, the economic evaluation demonstrated dominance of the benefits of Lp(a) testing, awareness of its additional risk and resulting lifestyle modifications outweighing the costs incurred due to Lp(a) testing, for both primary and secondary prevention of ASCVD. Conclusions In the absence of a targeted therapy, investing in Lp(a) testing, awareness about elevated Lp(a) levels and optimization of modifiable risk factors via lifestyle modifications will lead to significant benefits for the healthcare system. However, this will not mitigate the Lp(a) associated CV risk, hence, there is still an unmet need for Lp(a) targeting therapies.

The potential role of ischaemia-reperfusion injury in chronic, relapsing diseases such as rheumatoid arthritis, Long COVID, and ME/CFS: evidence, mechanisms, and therapeutic implications.

Ischaemia–reperfusion (I–R) injury, initiated via bursts of reactive oxygen species produced during the reoxygenation phase following hypoxia, is well known in a variety of acute circumstances. We argue here that I–R injury also underpins elements of the pathology of a variety of chronic, inflammatory diseases, including rheumatoid arthritis, ME/CFS and, our chief focus and most proximally, Long COVID. Ischaemia may be initiated via fibrin amyloid microclot blockage of capillaries, for instance as exercise is started; reperfusion is a necessary corollary when it finishes. We rehearse the mechanistic evidence for these occurrences here, in terms of their manifestation as oxidative stress, hyperinflammation, mast cell activation, the production of marker metabolites and related activities. Such microclot-based phenomena can explain both the breathlessness/fatigue and the post-exertional malaise that may be observed in these conditions, as well as many other observables. The recognition of these processes implies, mechanistically, that therapeutic benefit is potentially to be had from antioxidants, from anti-inflammatories, from iron chelators, and via suitable, safe fibrinolytics, and/or anti-clotting agents. We review the considerable existing evidence that is consistent with this, and with the biochemical mechanisms involved.

SISTEM MONITORING SPEED SETTING PADA ROLLER MIXER BERBASIS MIKROKONTROLER ARDUINO UNO

Roller mixer is a laboratory tool that serves to mix blood samples and reagents. In this case, the substances that are mixed are blood and anti-clotting agents (coagulants). In the process of mixing the blood, the timer and the rotational value of the motor are set by the selector switch. The design of the speed setting of the roller mixer tool is made so that the user can control and monitor how much the value of the motor speed used is displayed on the 16x2 LCD display. This research will be conducted at the Electronics Laboratory of Sari Mutiara University, Helvetia District, Medan City. This type of research method is experimental research, namely conducting direct experiments. The components in monitoring this tool are microcontroller, display, timer setting, speed setting and roller. After carrying out the research process on the design of this tool, the measurement results obtained from the Infrared Sensor are displayed on the LCD, with a minimum speed measurement of 36, Medium 38 and a maximum of 44 rpm. With a comparison from a thacometer with an average value of Minimum 44 Medium 54 and maximum 56.

Adverse effects of aspirin on hormonal and hastopathlogical changes in male rats

Aspirin (Acetylsalicylic acid) is widely used in human and veterinary as anti-inflammatory cardiovascular prophylaxis, anti-clotting agent and to decrease cancer risk. However, it is frequently mis- or over-consumed to prevent pain . Many hazards linked with its use have been recorded, but there is a lack of data on its effects on androgenic studies, testicular histology, kidney histology, liver histology, and reproductions.
 We tried to gather information on its adverse toxicity effects on male rat reproductive in this research. According to research, aspirin has a fatal effect on sperm production and reproductive hormones, as well as lowering testicular weight and altering blood profile. Because aspirin is a prostaglandin inhibitor, it may have an effect on the male reproductive system. Aspirin's detrimental toxic character is further revealed by liver damage.

Interpretable network propagation with application to expanding the repertoire of human proteins that interact with SARS-CoV-2.

BackgroundNetwork propagation has been widely used for nearly 20 years to predict gene functions and phenotypes. Despite the popularity of this approach, little attention has been paid to the question of provenance tracing in this context, e.g., determining how much any experimental observation in the input contributes to the score of every prediction.ResultsWe design a network propagation framework with 2 novel components and apply it to predict human proteins that directly or indirectly interact with SARS-CoV-2 proteins. First, we trace the provenance of each prediction to its experimentally validated sources, which in our case are human proteins experimentally determined to interact with viral proteins. Second, we design a technique that helps to reduce the manual adjustment of parameters by users. We find that for every top-ranking prediction, the highest contribution to its score arises from a direct neighbor in a human protein-protein interaction network. We further analyze these results to develop functional insights on SARS-CoV-2 that expand on known biology such as the connection between endoplasmic reticulum stress, HSPA5, and anti-clotting agents.ConclusionsWe examine how our provenance-tracing method can be generalized to a broad class of network-based algorithms. We provide a useful resource for the SARS-CoV-2 community that implicates many previously undocumented proteins with putative functional relationships to viral infection. This resource includes potential drugs that can be opportunistically repositioned to target these proteins. We also discuss how our overall framework can be extended to other, newly emerging viruses.

Natural Rubber Powder Production from Latex

Natural rubber-based products are widely used in everyday life. There are three types of upstream processed natural rubber, that are crumb rubber, conventional rubber, and concentrated latex. Latex is easily damaged by clotting and contains 35-40% w/w of water so that the packaging volume is relatively large and inefficient in transportation. Latex also contains ammonia as an anti-clotting agent so the packaging must be special to prevent unpleasant odour. This study aims to create a pilot plant of the spray drying latex from simulation results then test the performance, evaluate the performance test results, as well as making improvements to the production of rubber powder. The steps of this research are data collection for spray dryer design, design verification, construction of spray dryer, spray dryer appliance testing, and characterization of rubber powder produced. The heating system used in the spray dryer is LPG gas-fired furnace. Testing is done by varying the spray dryer drying air temperature of 120°C, 150°C, and 180°C, the water content of the feed latex 70% and 80% w/w, as well as non-stick material such as talc powder and MgO. Rubber powder characterized by water content with digital tools moisture meter and analysed spectra with Fourier Transform Infrared Spectroscopy (FTIR). The results showed the optimum operating conditions for the production of natural rubber powder is drying air temperature of 150°C and the water content of the feed latex 80% w/w. Natural rubber powder produced contains 10 to 13% w/w water but still sticky so that the powder grains stick to each other. The FTIR spectrum analysis of natural rubber powder products show similarity with bonding group of polyisoprene natural rubber compound. Natural rubber powder product can also be used as a substitute for crumb rubber.

Safest Time to Resume Oral Anticoagulation in Patients with Traumatic Brain Injury.

Objective: There is no standard protocol to guide the optimal time to resume anti-clotting agents after traumatic brain injury (TBI) in patients with a continued indication for anticoagulation/antiplatelet therapy (AAT). This study develops baseline data supporting a future prospective cohort study. We predict that there will be significantly decreased adverse events when AAT is started on or after Day 7.Methods: A retrospective chart review of 256 patients was performed. Patients admitted to a level I trauma center in West Texas between January 1, 2009, and December 31, 2012, on anti-clotting agents (specifically acetylsalicylic acid, coumadin, and/or clopidogrel) and who suffered a TBI were included. Patient metrics included admission coagulation studies, type of TBI and treatment, and time to continuation of AAT. Outcomes were assessed using follow-up appointment data. The primary outcome was death (mortality). Secondary outcomes included myocardial infarction, stroke, re-bleed, venous thromboembolism, and pneumonia.Results: A total of 256 patients met the inclusion criteria. However, only 85 patients on AAT presented for the six-month follow-up. Time to AAT resumption varied from immediate to 31 days. Out of the 85 patients, 32 patients never resumed AAT, 32 patients were restarted on AAT medication in less than seven days, 10 patients restarted medication between seven and 14 days, and 11 patients restarted AAT in more than 14 days. Adverse events occurred most infrequently in the AAT group resuming therapy between seven and 14 days (10%). Adverse events were most prevalent in the AAT group that never resumed therapy (68.8%).Conclusion: While most studies suggest that the safest time for resuming AAT lies between three and 10 days, our study revealed that adverse events were minimized in patients on AAT between seven and 9.5 days.

Anticlotting agents and the surgical management of glaucoma.

A large subset of patients with glaucoma uses anticlotting agents. No standardized guidelines currently exist for managing these agents in the specific perioperative setting of glaucoma surgery. The present review focuses on currently available anticlotting agents, their influence on hemorrhagic complications following glaucoma surgery, and management strategies for their use in the perioperative period RECENT FINDINGS: Anticlotting agents increase the risk of perioperative hemorrhagic complications following glaucoma surgery. Other factors that increase that risk have been identified as well, including the type of glaucoma surgery, preoperative intraocular pressure, postoperative hypotony, previous ocular surgeries, and race. Although general guidelines in the perioperative management of blood thinning agents exist, the best way to apply these guidelines specifically to glaucoma surgery remains unclear. Blood thinners are widely used and can increase the risk of hemorrhagic complications in patients undergoing glaucoma surgery. Managing these agents in the perioperative setting is challenging and should be done in collaboration with the patient's primary care provider, hematologist, or cardiologist. Management strategies should be tailored to each individual's risk of hemorrhage versus thromboembolism. Additionally, surgical plans can be modified to help minimize hemorrhagic outcomes, especially in patients who are deemed to be at high risk for perioperative bleeding.

Aspirin affect on Reproduction of Male Rat an-Overview

Aspirin (Acetylsalicylic acid) is used widely in human and veterinary as cardiovascular prophylaxis and as anti-inflammatory, anti-clotting agent and to decrease cancer risk. But there is a deficiency of information about its effects on androgenic studies histology of the testes, kidneys and livers and reproductions. In this paper we tried to collect the information about it deleterious toxicity effect on male rat reproduction and the reason of its side effects. Our finding shows that Aspirin has deadly effect the production of sperm, decrease the testis weight, decrease the production of testosterone and also affect the blood profile. Effect of aspirin on the male reproductive system may be due to being a Prostaglandins inhibitor, and According to all our findings probably it indicates that aspirin have deleterious effect on reproduction and the blood chemistry of male rats

Stroke and Cancer: Are Cryptogenic Strokes a Paraneoplastic Syndrome?

Cancer is an independent risk factor for ischemic stroke, and stroke can precede tumour diagnosis by many months. A paraneoplastic hypercoagulability has been implicated. Overall, cancer is a rare cause, but should be suspected in cases of cryptogenic stroke. In patients with cryptogenic stroke, two criteria – ischemic lesions in multiple vascular territories and D-dimer values >2,15 µg/ml – predict cancer with 100% specificity according to one relevant study. An adenocarcinoma at an advanced stage is identified in many cases, the risk of stroke-recurrence is high. There is a lack of evidence-based recommendations regarding secondary prevention in these cases. In analogy to the guidelines for venous thromboembolism in cancer patients, low molecular weight heparins might be more efficient compared to other anti-clotting agents.

Managing Bleeding and Emergency Reversal of Newer Oral Anticoagulants: A Review for Primary Care Providers

The therapeutic landscape for anticoagulation management is undergoing a shift from the use of traditional anticlotting agents such as heparins and warfarin as the only options to the growing adoption of newer target-specific oral anticoagulants (TSOACs) with novel mechanisms of action. Dabigatran, the first TSOAC approved for use in the United States, is a direct competitive inhibitor of thrombin. It has predictable kinetics, with an elimination half-life of 12 to 17 hours in healthy volunteers. Apixaban and rivaroxaban are selective inhibitors of factor Xa, and also display first-order kinetics. In younger healthy individuals, apixaban has an apparent half-life of approximately 12 hours, whereas rivaroxaban has an elimination half-life of 5 to 9 hours. Understanding the pharmacologic properties of these newer drugs can lead to better insights regarding their respective safety and efficacy profiles and their application in clinical practice. Laboratory assessments have been developed to measure the anticoagulant efficacy of these newer agents. However, the results of these tests can be highly variable, and are therefore not always useful for monitoring the anticoagulation effects of these agents. In addition, several strategies have been documented for the potential reversal of the anticoagulant effects of these drugs, from the temporary discontinuation of an agent before elective surgery to suggested emergency procedures in the case of major bleeding events. New, specific reversal agents for dabigatran, apixaban, and rivaroxaban are currently being developed, and dabigatran has received fast-track designation from the US Food and Drug Administration. Until comprehensive clinical guidelines are developed, institutions involved in emergency care should establish their own procedures for the management of patients undergoing anticoagulation who require emergency treatment. These protocols should include appropriate laboratory testing to assess anticoagulant activity as part of the inpatient workup if time allows, and the potential use of hemodialysis, prohemostatic agents, and reversal agents when available.

The crystal structure of the active domain of AAPP, a powerful anti-coagulant, in complex with an antibody

Blood clotting is a vitally important process that must be carefully regulated to prevent blood loss on one hand and thrombosis on the other. Severe injury and hemophilia may be treated with pro-coagulants, whereas risk of obstructive clotting or embolism may be reduced with anti-coagulants. Anti-coagulants are an extremely important class of drug, one of the most widely used types of medication, but there remains a pressing need for novel treatments however as present drugs such as warfarin have significant drawbacks. Nature provides a number of examples of anti-coagulant proteins produced by blood-sucking animals, which may provide templates for the development of new small molecules with similar physiological effects. We have therefore studied an Anopheles anti-platelet protein (AAPP) from a malaria vector mosquito, and report its crystal structure in complex with an antibody. Overall the protein is extremely sensitive to proteolysis, but the crystal structure reveals a stable domain built from two helices and a turn, which corresponds to the functional region. The antibody raised against AAPP prevents it from binding collagen. Our work therefore opens new avenues to the development of both novel small molecule anti-clotting agents and anti-malarials.

The Crystal Structure of the Active Domain of Anopheles Anti-platelet Protein, a Powerful Anti-coagulant, in Complex with an Antibody

Blood clotting is a vitally important process that must be carefully regulated to prevent blood loss on one hand and thrombosis on the other. Severe injury and hemophilia may be treated with pro-coagulants, whereas risk of obstructive clotting or embolism may be reduced with anti-coagulants. Anti-coagulants are an extremely important class of drug, one of the most widely used types of medication, but there remains a pressing need for novel treatments, however, as present drugs such as warfarin have significant drawbacks. Nature provides a number of examples of anti-coagulant proteins produced by blood-sucking animals, which may provide templates for the development of new small molecules with similar physiological effects. We have, therefore, studied an Anopheles anti-platelet protein from a malaria vector mosquito and report its crystal structure in complex with an antibody. Overall the protein is extremely sensitive to proteolysis, but the crystal structure reveals a stable domain built from two helices and a turn, which corresponds to the functional region. The antibody raised against Anopheles anti-platelet protein prevents it from binding collagen. Our work, therefore, opens new avenues to the development of both novel small molecule anti-clotting agents and anti-malarials.

Special invertebrate models and integrative medical applications: regulations, mechanisms, and therapies.

This special issue of eCAM has brought together several unique investigators interested in invertebrate animal models. Investigators would benefit by examining advances and applications of findings derived from useful terrestrial and marine invertebrate animal models. Results derived from well-defined evidence-based approaches are usually relevant to humans; the advantages are numerous, inexpensive, and noncontroversial and are not subject to rigid, ethical, or moral guidelines. In the historical context, these animals have been crucial in many cultures before the advent of industrial medicines thus providing the only source of aid. Now, there is a move to return to or at least to include these practices lest they disappear since, in certain cultures, they represent the sole source of useful health remedies. However, evidence-based medicine emphasizes the importance of subjecting animal products to rigorous analysis. Results are then standardized and serve to educate populations including those that use exclusively western practices. eCAM stands ready to accept the importance and contributions of bees as valuable sources of beneficial activities (pollination) and products (honey and propolis) that for centuries have enhanced human lives as food and medicine. Others include corals, millipedes, maggots, and earthworms. Corals are marine invertebrates that live in compact colonies. Humans have learned that they are useful in the manufacture of jewelry and chemical compounds that are useful against cancer, AIDS, and pain and serve as skeletons during bone grafting. Millipedes are arthropods (the same group as shrimps, crabs, butterflies, and bees) which in some cultures are used during pregnancy and as cures for fever, wounds, earaches, and hemorrhoids and food among the Bobo people of Burkina Faso when crushed; sometimes they are boiled and eaten in tomato sauce. Since the time of Napoleon and even centuries earlier, maggots have been used especially in patients with severe intractable wounds caused by nerve degeneration that results from diabetes. In fact, leeches and maggots are now valuable components of the emerging field of biotherapy, the therapeutic use of living creatures to clean gangrenous tissue often found in ulcers, burns, and postoperative infections. Earthworms are experiencing growing popularity due to their many applications including sources of high protein as food and the production of an anticlotting agent known as lumbrokinase that dissolves blood clots in patients. Aside from observations and usefulness by the layman, certain techniques are valuable as molecular biologists strive to understand the minute structure of molecules in order to improve therapies. Let us not forget the contributions of earthworms as tillers of the soil which enhance agricultural output. Earthworms keep the soil aerated by their constant churning which makes for improved yield of plants regardless of the proposed use. Chih-Yang Huang Edwin L. Cooper Catherine Fang-Yeu Poh Wei-Wen Kuo Tung-Sheng Chen Ronald Sherman

Medication errors in hospitalised children

This study aims to explore the characteristics of reported medication errors occurring among children in an Australian children's hospital, and to examine the types, causes and contributing factors of medication errors. A retrospective clinical audit was undertaken of medication errors reported to an online incident facility at an Australian children's hospital over a 4-year period. A total of 2753 medication errors were reported over the 4-year period, with an overall medication error rate of 0.31% per combined admission and presentation, or 6.58 medication errors per 1000 bed days. The two most common severity outcomes were: the medication error occurred before it reached the child (n = 749, 27.2%); and the medication error reached the child who required monitoring to confirm that it resulted in no harm (n = 1519, 55.2%). Common types of medication errors included overdose (n = 579, 21.0%) and dose omission (n = 341, 12.4%). The most common cause relating to communication involved misreading or not reading medication orders (n = 804, 29.2%). Key contributing factors involved communication relating to children's transfer across different clinical settings (n = 929, 33.7%) and the lack of following policies and procedures (n = 617, 22.4%). More than half of the reports (72.5%) were made by nurses. Future research should focus on implementing and evaluating strategies aimed at reducing medication errors relating to analgesics, anti-infectives, cardiovascular agents, fluids and electrolytes and anticlotting agents, as they are consistently represented in the types of medication errors that occur. Greater attention needs to be placed on supporting health professionals in managing these medications.

Outcome of the consultation with Member States and EFSA on the basic substance application for calcium hydroxide and the conclusions drawn by EFSA on the specific points raised

EFSA Supporting PublicationsVolume 10, Issue 10 488E Technical reportOpen Access Outcome of the consultation with Member States and EFSA on the basic substance application for calcium hydroxide and the conclusions drawn by EFSA on the specific points raised European Food Safety Authority (EFSA), European Food Safety Authority (EFSA)Search for more papers by this author European Food Safety Authority (EFSA), European Food Safety Authority (EFSA)Search for more papers by this author First published: 18 October 2013 https://doi.org/10.2903/sp.efsa.2013.EN-488Citations: 1 Published date: 18 October 2013 Question number: EFSA-Q-2013-00402 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References Anonymous, 2003. Title: Calcium balance in orchards on different soil types, treated with calcium hydroxide against fruit tree canker Source: Request to amend Annex IIB-Pesticides, Annex I. van Rooijen, H, 2006. Title: Evaluation of calcium hydroxide and anti-clotting agents in surface water. Source: Hoogheemraadschap De Stichtse Rijnlanden, Houten (NL). Evaluation based on the criteria in CIW report “Het beoordelen van stoffen en preparaten voor de uitvoering van het emissiebeleid water” (judgement of substances and preparations in the framework of emission management water). Details of the evaluation not available. Schärer, HJ. A., Häseli, C., Daniel, J., Fuchs, L., Tamm; 2010. Title: Praxisversuche 2010 mit Löschkalk und Hanfextrakt gegen Feuerbrand. Source: Öffentlicher Schlussbericht 2010. SCOEL (Scientific Committee on Occupational Exposure Limits), 2008. Recommendation from the Scientific Committee on Occupational Exposure Limits for Calcium oxide (CaO) and calcium hydroxide (Ca(OH)2). SCOEL/SUM/137. February 2008. Citing Literature Volume10, Issue10October 2013488E ReferencesRelatedInformation

An effect of anticoagulants on the FTIR spectral profile of mice plasma

BACKGROUND: Although, it is well known that various types of anticoagulant influence on plasma biochemistry in clinical chemistry analysis, the evaluation of such an effect on IR spectrum of plasma has not been reported so far. OBJECTIVE: In this study, we compare FTIR spectra of plasma films from healthy mice C57Bl/6J, which were collected by application of various types of anti-clotting agents such as low molecular heparin, trisodium citrate, EDTA and aspisol. METHODS: FTIR spectra were recorded using Fourier Transform Infrared imaging and evaluated with a support of Principal Component Analysis (PCA). RESULTS: We found significant changes in spectral profile of plasma among three groups of anticoagulants: (1) nadroparine administrated intraperitoneally and blood collected by using aspisol, (2) citrate, and (3) EDTA, heparin and EDTA/aspisol. The spectral variation is mainly found in the regions associated with proteins and lipids. CONCLUSIONS: Spectral features found in this study indicate the alternation in structure of plasma proteins as well as lipids/fatty acids. This suggests a careful choice of the anticoagulant in clinical/pharmacological studies on plasma with the use of FTIR spectroscopy.

Revisiting the Role of the Stat Laboratory: Is It Safe to Perform Activated Clotting Time Determinations (ACTs) Out of the Operating Room

Abstract 4256 Background:Activated clotting time (ACT) is determined during cardiac procedures in order to assess the level of anti-coagulation. There are three main anticoagulants used during cardiac procedures:heparin, angiomax and Plavix. Heparin is often used in the cardiac OR for major procedures and is neutralized, over time, by platelet factor 4(PF4). Angiomax, bivalirudin, has a quick onset of action, but a much shorter half-life when compared to Heparin. Plavix, clopidogrel, irreversibly inhibits platelets from clotting and is used on patients in need of anticoagulation for an extended period of time. The purpose of this study was to evaluate the stability of ACT results over time utilizing different coagulation regimens. If the ACT value remains stable over time, this would enable us to remove the device from the OR and place it in a stat laboratory. Methods:ACTs were determined by the ISTAT (Abbott), a hand held point of care device, using kaolin activated cartridges. A single blood sample was obtained and was evaluated at intervals of 0, 5, 10, 15, and 20 minutes. In addition, temperature, age, body surface area and platelet count of patient were recorded. The time 0 specimen was used to determine the patients ACT and interval testing was performed on the remnant. Results:36 samples representing 22 patients had ACT tests performed using the ISTAT. There was no significant change from 0 to 20 minutes over the entire dada set. However, when divided into different anti-clotting agents there were significant changes. Patients who had only taken Angiomax had a significant difference within the first 5 minutes (p value=.0094). Patients taking Angiomax and Plavix together had no change in ACT values at 20 minutes. Patients on Heparin alone demonstrated a loss of ACT stability at 10 minutes with values both increasing and decreasing. Conclusions:Patients on Angiomax alone demonstrated a significant difference in ACT value within the first 5 minutes and all intervals thereafter. Based on Angiomax short half-life the ACT should be performed as soon as possible. The ACT values in patients taking both Angiomax and Plavix achieved steady state throughout the 20 minutes and had little if any decrease in value. The results for the Heparin group were unreliable at 10 minutes. As a result of these findings, performing an ACT outside the OR is feasible assuming the test can be performed by 10 minutes. Disclosures:No relevant conflicts of interest to declare.

Toxoplasma gondiiPresence in Women with Spontaneous Abortion in Yucatan, Mexico

The objective of this study was to estimate the seroprevalence of anti- Toxoplasma gondii antibodies and DNA of women with spontaneous abortions in 2 hospitals located in Yucatan, Mexico. Between June 2008 and May 2009, blood samples were taken from 100 women with spontaneous abortion attending the Ticul City Communitarian Hospital and the Merida Mother-Kid Hospital. The sera were tested for anti- T. gondii IgG and IgM antibodies. Blood samples (5 ml with anticlotting agent) were also used for polymerase chain reaction (PCR) assay, to detect T. gondii DNA. Forty-two of the 100 samples were negative. Of the positive samples (n = 58), 32 were positive to IgG, 2 to IgM, 5 to IgG and IgM, 6 to IgG and PCR, 1 to IgM and PCR, and 12 to IgG, IgM, and PCR. Accordingly, 55% of the women were seropositive to at least IgG, 20% to at least IgM, and 19% via PCR. Differences between hospitals were significant (P < 0.05) only for IgM. The risk of infection (IgM positive) was 2.85 (odds ratio [OR] 95%, confidence interval [CI]; 1.03-7.87) times greater in women patients at the Merida Mother-Kid Hospital, than those at the Ticul Communitarian Hospital. More studies are needed to evaluate the impact of this disease and to establish strategies to follow in order to reduce congenital toxoplasmosis in the populations at risk.

Unique vascular protective properties of natural products: supplements or future main-line drugs with significant anti-atherosclerotic potential?

Natural health products (NHP) which include minerals, vitamins and herbal remedies are not generally considered by medical practitioners as conventional medicines and as such are not frequently prescribed by health centre’s as either main-line or supplemental treatments. In the field of cardiovascular medicine, studies have shown that typically, less than half of patients suffering from coronary syndromes chose to take any form of NHP supplement and these products are rarely recommended by their medical practitioner. Vascular/endothelial cell damage is a key instigator of coronary arterial plaque development which often culminates in thrombosis and myocardial infarction (MI). Current treatment for patients known to be at risk of primary or secondary (MI) includes lipid lowering statins, anti-clotting agents (e.g. tissue plasminogen activator; tPA) and drugs for stabilization of blood pressure such as beta-blockers. However, evidence has been building which suggests that components of at least several NHP (e.g. aged garlic extract (AGExt), resveratrol and green tea extracts (GTE)) may have significant vascular protective effects through reduction of oxidative stress, lowering of blood pressure, reduction in platelet aggregation, vasodilation and inhibition of abnormal angiogenesis. Therefore, in this review we will discuss in detail the potential of these substances (chosen on the basis of their potency and complimentarity) as anti-atherosclerotic agents and the justification for their consideration as main-line additional supplements or prescriptions.