Hemostasis Parameters Research Articles

Therapeutic effects of dietary antioxidative supplements on the management of type 2 diabetes and its complications; umbrella review of observational/trials meta-analysis studies.

Controversial data on the effects of vitamins (V) and nutrients on the management of type 2 diabetes mellitus (T2DM) is available. Thus, it is aimed to clarify the role of vitamins and nutrients through an umbrella review regarding the available observational/ trials meta-analyses. All meta-analyses of observational and clinical trials conducted on the impact of vitamins and nutrients in T2DM published until 5th June 2021 in PubMed or Web of Sciences were included in this review. Also, the meta-analysis on children, pregnant women, type 1 DM, or in vivo/in vitro studies was excluded. Search results were reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flowchart. The overall of 93 papers (99 studies) consisting of 75 trials and 24 observational studies were included. Most studies were conducted on the effect of VD and alpha-lipoic acid (ALA) in both genders. Consumption of VD or its analogous; 20IU/d to 450,000IU/once for 3weeks to 7years showed to have a positive effect on the parameters of glucose hemostasis. Moreover, an inverse association was observed between VD level and T2DM risk. Daily consumption of 1200mg VC for at least 12weeks improved lipid profile and glucose hemostasis parameters. Furthermore, VB and medications for diabetic polyneuropathy (DPN) increased nerve conduction velocity. Vitamins K and E were showen to not have significant impact on T2DM. ALA had a beneficial effect on DPN symptoms after 2-4weeks of intake of at least 300mg/d. T2DM risk was reduced by doubling ALA intake. The effective daily doses of chromium, zinc and coenzyme Q10 on lipid profile and glucose hemostasis parameters were > 200mg, < 25mg, and < 200mg, respectively. This umbrella review suggests that dietary vitamins and nutrients can result in protective impacts the complications associated with T2DM. However, due to discrepancies between the results of the trials and observational studies is essential to conduct long-term high-qualified studies to prove the beneficial therapeutic effects of the vitamins and nutrients on T2DM and its complications.

Hemostasis features in pregnant women with hypertensive disorders living in the highlands of Tadzhikistan Republic

Introduction.One of the actual problems of modern obstetrics is hypertensive disorders during pregnancy. Pregnant women living in highlands are exposed to adverse factors, the most important of which is decreased oxygen in the air. Hypertension of pregnant women in high altitude conditions is conjoin with exogenous hypobaric hypoxia, and as a total organ pathology leads to functional and morphological changes in all organs and systems.Aim:to study the features of hemostasis system in pregnant women with hypertensive disorders in highlands.Materials and Мethods.A prospective comparative study included 114 pregnant women with hypertensive disorders, which were divided into 2 groups: group 1 – 63 pregnant women living in highlands, and group 2 – 51 pregnant women living in lowlands. In group 1, 42 pregnant women (67 %) and in group 2, 24 (47 %) pregnant women were diagnosed with severe preeclampsia. Hemostasis parameters were studied: blood clotting time, prothrombin index, content of fibrinogen and soluble fibrin-monomer complexes (SFMC), international normalized ratio (INR), activated partial thromboplastin time (APTT) index, thrombin time, platelet count.Results.In pregnant mountaineers, compared with pregnant women in lowlands, a higher content of such hemostasis parameters as APTT index (1.654 ± 0.426 vs. 0.892 ± 0.1145; p &lt; 0.001) and SFMC level (4.921 ± 0.753 mg% vs. 3.590 ± 0.5676 mg%; p &lt; 0.001), thrombin time values (103.206 ± 3.734 seconds vs. 93.920 ± 7.8268 seconds; p &lt; 0.001) were revealed, as well as lower fibrinogen concentration (3.762 ± 0.809 g/l vs. 4.160 ± 1,3015 g/l; p = 0.048).Conclusion.In pregnant women living in highlands compared with pregnant women in lowlands with the addition of severe forms of preeclampsia (67 % vs. 47 %) hypercoagulation characteristic of normal pregnancy disappears, but, on the contrary, iso- and hypocoagulation appears.

FEATURES OF THE PARAMETERS OF RED BLOOD CELLS AND HEMOSTASIS IN PATIENTS WITH STROKES ASSOCIATED WITH CORONAVIRUS INFECTION

Objective: The purpose is to identify the peculiarities of the parameters of red blood cells (RBC) and hemostasis in patients with strokes associated with coronavirus infection. Design and method: A total of 124 patients (48.5 + 1.9 years) with impairments of cerebral circulation due to COVID-19 (confirmed by positive PCR test) had been examined. Among them, 74 patients had ischemic stroke, 25– transient ischaemic attack, 17– intracerebral hemorrhage, 8– subarachnoid hemorrhage. The parameters of hemostasis were measured by standard methods, electrical, viscoelastic parameters of RBC - by dielectrophoresis. Results: 71 patients (the 1st group) showed signs of intravascular coagulation and thrombosis: accelerated platelet-leukocyte aggregation, increased levels of coagulation products, reduced fibrinolysis activity (p = 0.001–0.04). The levels of D-dimer, fibrinogen, ESR, platelet count were higher in this group compared to the second one (p &lt; 0.01). A moderate increase of RBC summarized rigidity, viscosity was noted. The level of RBC hemolysis was associated with platelet count (r = 0.735,p = 0.03), D-dimer (r = 0.482, p &lt; 0.05), fibrinogen level (r = 0.374, p = 0.04). In 2nd group (53 persons), the markers of thrombosis had moderate deviations. Sharply reduced RBC deformability with increased summarized rigidity, viscosity was dominant coupled with the background of high electrical conductivity of cell membranes compared to the indicators in the 1st group (p &lt; 0.01). There was a decrease of membrane capacity, surface charge, cell dipole moment, polarizability than those in the 1st group (p = 0.0001–0.05). A sharp decrease of RBC deformability creates obstacles to overcoming small-diameter capillaries, leading to violations of microcirculatory blood flow. RBC deformability was associated with levels of ferritin (r = 0.451, p = 0.02), HbA1c (r = 0.480, p = 0.03), uric acid (r = -0.371, p &lt; 0.05), LDL cholesterol (r = 0.461, p = 0.02). Incubation of blood samples in vitro for 10 min with riboflavin, nicotinamide, inosine, which ensures RBC energy metabolism, restored the reduced RBC deformability (p &lt; 0.01), altered cell morphology (p = 0.04), decreased RBC aggregation (p &lt; 0.001). Conclusions: The revealed features of parameters of RBC hemostasis in stroke patients with coronavirus infection are associated with two independent pathogenetic mechanisms: thrombotic and hemorheologic. The thrombotic variant is due to procoagulant state and an activity of inflammation. The hemorheologic variant is caused by decrease of RBC energy metabolism, activity of enzymes.

Diagnosis of asymptomatic bone metastases from breast cancer.

e13042 Background: The purpose of this study was to analyze the prognostic value of blood levels of fibrinogen (F) in bone metastases from breast cancer (BC). Methods: The study included 160 patients with nodular BC pT2-3N0-1M0-1, including 48 patients in a prospective group (PG) and 112 patients in a retrospective group (RG). All patients underwent initial clinical and laboratory examinations, including determination of alkaline phosphatase (AP) activity (Cobas Integra 4000 plus, Switzerland) and parameters of coagulation hemostasis (STA Compact, France). Bone scintigraphy was performed for complaints of bone pain and/or in cases of elevated AP activity, regardless of SXCT data. Results were considered statistically significant at p &lt; 0.05. Results: Patients in PG were divided into two subgroups depending on F levels: in 31 (64.6%) patients F = 3.67±0.5 g/L, insignificantly exceeding the norm (2.8±0.3 g/L); in 17 (35.4%) patients F = 6.9±0.3 g/L, being 1.9 and 2.5 times (p &lt; 0.05) higher than in subgroup 1 and the norm, respectively. AP activity exceeded the norm by 26% and 40%, respectively (p &lt; 0.1). Bone metastases were detected before treatment in 24 (21.4%) women of RG with pain syndrome; all these patients showed increased blood levels of F, on average up to 7.86±0.8 g/L, similarly to patients in subgroup 2 of PG. F levels in other 88 (78.6%) patients in RG were 3.4±0.6 g/L. The nature and severity of AP changes in RG patients and in both PG subgroups were similar. Initially elevated F levels in 17 PG patients remained unchanged after antitumor treatment (6.2±0.6 g/L). AP activity values were stable after treatment being only 36% and 28% (p &lt; 0.1) higher than the norm, respectively. None of the patients with high F levels complained about bone pain. Unscheduled bone scintigraphy was appointed to 17 patients of PG without clinical symptoms or x-ray (SXCT) signs of pathology but with initially high F which did not decline after treatment. Bone scintigraphy showed metastases to the spine and pelvic bones in 12 of 17 (70.5%) patients 1 month after treatment, subsequently confirmed by MRI results. Conclusions: Initial levels of F within 6.9±0.6 g/L which do not decline after the special treatment allow predicting unfavorable BC course and the presence of metastases to the spine and/or pelvic bones without clinical signs of progression. The proposed method allows diagnosis of advanced tumor process in the absence of clinical signs of the disease with an accuracy of 87.8%, and allows timely corrections to the treatment plan.

Modern Aspects of Burn Injury Immunopathogenesis and Prognostic Immunobiochemical Markers (Mini-Review).

Burn injuries are among the most common peacetime injuries, with mortality ranging from 2.3% to 3.6%. At the same time, 85–90% of patients with burns are people of working age and children. Burn injury leads to metabolic disorders and systemic inflammatory response, inefficient energy consumption, and other physiological changes that can lead to dysfunction of organs and systems. The most formidable complication of burn injuries is sepsis mediated by multiple organ failure, the most common cause of poor prognosis in patients and has specific differences in these injuries. The purpose of this article was to dwell in detail on the most promising immunobiochemical markers of sepsis in the format of a mini-review, based on the main aspects of the immunopathogenesis of this complication. The pathogenesis of a burn injury and any general pathological process is based on an inflammatory reaction and large-scale changes in the skin and mucous membranes. This review is devoted to the progress in understanding the main aspects of the immunopathogenesis of burn lesions and the features of post-burn immune dysfunction, manifested by disorders in the innate and adaptive immunity systems. Attention is focused on the role in the immunopathogenesis of the development of systemic and local disorders in burn injury. Characterization of primary immunobiochemical markers of burn injury (cytokines, growth factors, C-reactive protein, procalcitonin, presepsin, matrix metalloproteinases, reactive oxygen species, nitric oxide, hemostasis parameters) is presented. The problem of treating burn lesions is associated with constant monitoring of the condition of patients and regular monitoring of specific immunobiochemical markers predicting sepsis for the timely initiation of a specific therapy.

DNA damage in peripheral blood lymphocytes of severely ill COVID-19 patients in relation to inflammatory markers and parameters of hemostasis.

Bearing in the mind that a variety of agents can contribute to genome instability, including viral infections, the aim of this study was to analyze DNA damage in hospitalized COVID-19 patients and its relationship with certain laboratory parameters. The potential impact of applied therapy and chest X-rays on DNA damage was also estimated. The study population included 24 severely COVID-19 patients and 15 healthy control subjects. The level of DNA damage was measured as genetic damage index (GDI) by comet assay. The standard laboratory methods and certified enzymatic reagents for the appropriate autoanalyzers were performed for the determination of the biochemical and hematological parameters. COVID-19 patients had significantly higher level of DNA damage compared with control subjects. The absolute number of neutrophil leukocytes was statistically higher, while the absolute number of lymphocytes was statistically lower in COVID-19 patients than in healthy controls. The analysis of the relationship between DNA damage and laboratory parameters indicated that GDI was positively correlated with interleukin 6 (IL-6) concentration and negatively with platelet count in COVID-19 patients. The level of DNA damage was slightly higher in female patients, in whom it was demonstrated a positive correlation of GDI with C-reactive protein (CRP) and procalcitonin. Likewise, there was a negative relationship of GDI and platelet count, and positive relationship of GDI and activated partial thromboplastin time (aPTT) in female population. The applied therapy (antibiotics, corticosteroid, anticoagulant, and antiviral therapy) as well as chest X rays has been shown to have genotoxic potential. The level of DNA damage significantly corresponds to the inflammatory markers and parameters of hemostasis in COVID-19 patients. In conclusion, inflammation, smoking habit, applied therapy, and chest X rays contribute to a higher level of DNA damage in COVID-19 patients.

Effect of oral vitamin D supplementation on dry eye disease patients with vitamin D deficiency

ABSTACTClinical relevanceDry eye disease (DED) and vitamin D deficiency are both common clinical entities. Vitamin D has been reported to play a significant role in ocular surface homeostasis.BackgroundThis study aimed to determine the therapeutic effect of oral vitamin D supplementation in dry eye disease patients with vitamin D deficiency.MethodsA randomized, controlled study was completed in 100 patients with dry eye disease and concurrent vitamin D deficiency (< 20 ng/ml). Participants were randomly allocated to 8 weeks of oral vitamin D supplementation with both groups receiving conventional dry eye treatment with artificial tears. Schirmer’s, tear break-up time (TBUT) and osmolarity tests were measured before and after eight weeks of treatment.ResultsThe mean age of participants was 36.8 ± 8.56 years in the treatment group (n: 50) and 34.8 ± 10.13 year in the control group (n: 50). After eight weeks of treatment the mean differences in Schirmer’s, TBUT and tear osmolarity were 2.38 ± 1.55 mm, 3.95 ± 1.48 s and −16.9 ± 6.28 mOsm/L, respectively in the treatment group, and 0.7 ± 0.86 mm, 0.92 ± 1.57s and −3.34 ± 2.0 mOsm/L respectively in the control group (p < 0.001 for all parameters). The treatment group demonstrated a more significant improvement than the control group in Schirmer’s, TBUT and osmolarity values (p < 0.001).ConclusionVitamin D supplementation as an adjuvant to routine dry eye treatment improves ocular surface hemostasis parameters, results in better tear stability and a more improved tear osmolarity in patients with vitamin D deficiency.

The status of some hemostasis parameters in children with acute leukemia after chemotherapy

Aim. To improve treatment outcomes of children with acute leukemia after chemotherapy.Materials and Methods. Eighty-five children with AL who were treated at the Department of Pediatric Hematology of the National Medical Center of Tajikistan “Shifobakhsh” and the Regional Cancer Center of Bokhtar during the period 2015-2019 were studied. The study group included 32 children diagnosed with AML and 53 with ALL.All children underwent a comprehensive examination including clinical, X-ray and endoscopic, laboratory tests, ultrasound, CT scan, sternal puncture, and analysis of cerebrospinal fluid.Results and discussion. On admission to the hospital, all hospitalized children had a complete clinical and laboratory picture of AL.We studied 2 groups of patients with AL who received KIT by two schemes. Group 1 - patients with AL received standard therapy. Group 2 - patients with AL, in addition to the standard regimen, received reamberine in combination with remaxol. These medications can protect patients with AL from the toxicity of chemotherapeutic agents used for the treatment of AL, at the same time they don’t decrease the antitumor action of chemotherapeutic agents.Conclusions.1. A marked impairment of hemostasis in children with AL compared to healthy children is observed.2. Conducting KIT in children in combination reamberine with remaxol is more effective compared to standard therapy, as markers of intoxication are significantly reduced.

Evaluation of novel coagulation and platelet function assays in patients with chronic kidney disease

BackgroundHemostasis evaluation in chronic kidney disease (CKD) is critical for optimal management of thrombotic and bleeding events. Standard coagulation screens are inadequate for predicting coagulopathy in CKD. ObjectiveTo evaluate hemostasis parameters in patients with different stages of CKD using novel coagulation assays. Patients/MethodsCross‐sectional study of 30 healthy controls (HC) and 120 CKD patients (10 Stage 2, 20 Stage 3, 20 Stage 4, 20 Stage 5 not requiring renal replacement therapy, 20 transplant, 10 newly started on hemodialysis [HD], 20 established on HD). Standard laboratory tests were performed in addition to rotational thromboelastometry (ROTEM), multiple electrode aggregometry (MEA), thrombin generation assays, D‐dimer, and markers of thrombogenesis (thrombin‐antithrombin [TAT]), fibrinolysis, and endothelial activation (intercellular adhesion molecule‐1 [ICAM‐1]). ResultsD‐dimer, TAT, and ICAM‐1 concentrations were significantly higher in patients with CKD than HC (P < .01). ROTEM maximum clot firmness was significantly higher in patients than in HC (P < .01). In CKD Stage 5 patients (pre‐HD and started HD) adenosine diphosphate and thrombin receptor activating peptide MEA tests were significantly lower than HC indicating platelet aggregation defect (P < .05). Multivariate analysis confirmed the direct effect of estimated glomerular filtration rate (eGFR) in the variance of ROTEM and MEA tests. Endogenous thrombin potential and peak thrombin were not statistically different between groups, but Stage 5 CKD patients had prolonged lag time (7.91 vs. 6.33, P < .001) and time to thrombin peak (10.8 vs. 9.5, P < .05) compared to HC. ConclusionsPatients with CKD exhibit features of concomitant hypercoagulability measured by ROTEM and platelet dysfunction measured with MEA. eGFR was an independent determinant of platelet dysfunction and hypercoagulability.

DIAGNOSTIC SIGNIFICANCE OF COAGULOGRAM PARAMETERS FOR ASSESSMENT OF STRESS CONDITIONS IN EXPERIMENTAL STRESS MODEL CONDITIONS OF CARP (CYPRINUS CARPIO) AND TILAPIA (OREOCHROMIS NILOTICUS)

The paper presents research results of reaction of some parameters of secondary hemostasis of commercial fish - carp Cyprinus carpio and tilapia Oreochromis niloticus to stress of various durations induced by corticosteroids (dexamethasone and betamethasone). The purpose of the work was to determine the earliest changing coagulogram parameters of fish under conditions of experimental stress model and to assess the suitability of these parameters for early diagnosis of stress reactions. The study was carried out in Vologda region, the fish were divided into three groups: fish with chronic stress, with acute stress and control animals, their blood was taken by puncture of the tail vein before hormone treatment, and then 7 and 21 days after. The following changes in coagulogram parameters were studied: thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), concentration of fibrinogen and soluble fibrin-monomer complexes (SFMC), antithrombin III. It was found that the level of plasma fibrinogen, the concentration of which is directly proportional to stress duration is the earliest and the most explicitly reacting to stress influence for carps. As far as tilapia is concerned, many parameters of hemostasis were more sensitive to the effects of prolonged stress compared to controls: a decrease of APTT, PT, fibrinogen concentration, and an increase of SFMC. These parameters can be determined as markers (bioindicators) of development of stress conditions in these fish species.

Prospective analysis of laboratory blood parameters in patients with cardiovascular diseases who underwent COVID-19-associated pneumonia.

The study of the characteristics and dynamics of laboratory biomarkers in patients with cardiovascular diseases (CVD) undergoing COVID-19-associated pneumonia may be of great clinical importance. The study included 116 patients who underwent COVID-19-associated pneumonia. The patients were divided into 2 groups. The first group included 49 patients without CVD, the second group - 67 patients with CVD. A blood sample was performed in all patients at the time of hospitalization and 3 months after discharge from the hospital. The parameters of general blood count, biochemistry, hemostasis, and biomarkers of inflammation were assessed - concentration of C-reactive protein (CRP), highly sensitive CRP (hs-CRP), homocysteine and IL-6. All patients initially underwent computed tomography of the chest organs. We found that ESR, WBC (leukocytes), NLR (neutrophils/lymphocytes ratio), fibrinogen, LDH (lactate dehydrogenase), LYM/CRP ratio (lymphocytes/CRP) were parameters that significantly distinguished patients in the 1st and 2nd groups. Three months after discharge from the hospital in patients of both groups the increased indicators approached the reference values, however, some parameters such as CRP, ESR, WBC, fibrinogen remained at a higher level in group 2 compared to group 1. Correlation analysis revealed the relationship between parameters of inflammation and hemostasis in the 2nd group of patients, which confirms the presence of latent vascular inflammatory potential in this group. It was revealed that such indicators as lymphocytes, neutrophils, APTT and LDH were associated with the initial volume of lung lesion more than 50%. Increase of these parameters by 1 unit contributes to increase in the volume of lung tissue damage by 6.5%, 6.4%, 11%, and 0.6%, respectively. Thus, dynamic control of laboratory parameters has prognostic value in assessing the nature of the course of COVID-19 associated pneumonia in patients with CVD and developing an algorithm for personalized monitoring of patients in the post-COVID period with the aim of timely correction of therapy to prevent unwanted vascular complications.

Evolving Risk of Acute Kidney Injury in COVID-19 Hospitalized Patients: A Single Center Retrospective Study.

Background and Objectives: Within a year, COVID-19 has advanced from an outbreak to a pandemic, spreading rapidly and globally with devastating impact. The pathophysiological link between COVID-19 and acute kidney injury (AKI) is currently being debated among scientists. While some studies have concluded that the mechanisms of AKI in COVID-19 patients are complex and not fully understood, others have claimed that AKI is a rare complication of COVID-19-related disorders. Considering this information gap and its possible influence on COVID-19-associated AKI management, our study aimed to explore the prevalence of AKI and to identify possible risk factors associated with AKI development among COVID-19 hospitalized patients. Materials and Methods: A retrospective cohort study included 83 laboratory-confirmed COVID-19 patients hospitalized at the isolation department in a tertiary hospital in Zagazig City, Egypt between June and August 2020. Patients younger than 18 years of age, those diagnosed with end-stage kidney disease, or those on nephrotoxic medications were excluded. All study participants had a complete blood count, liver and renal function tests, hemostasis parameters examined, inflammatory markers, serum electrolytes, routine urinalysis, arterial blood gas, and non-enhanced chest and abdominal computer tomography (CT) scans. Results: Of the 83 patients, AKI developed in 24 (28.9%) of them, of which 70.8% were in stage 1, 8.3% in stage 2, and 20.8% in stage 3. Patients with AKI were older than patients without AKI, with hypertension and diabetes being the most common comorbidities. Risk factors for AKI include increased age, hypertension, diabetes mellitus, and a higher sequential organ failure assessment (SOFA) score. Conclusions: AKI occurs in a considerable percentage of patients with COVID-19, especially in elderly males, those with hypertension, diabetes, and a higher sequential organ failure assessment (SOFA) score. Hence, the presence of AKI should be taken into account as an important index within the risk spectrum of disease severity for COVID-19 patients.

Coagulation abnormalities in patients with COVID-19 on venovenous ECLS increased risk for technical complications and support times but had no impact on survival.

BackgroundPatients with severe coronavirus disease‐19 (COVID‐19)‐associated acute respiratory distress on venovenous extracorporeal lung support (V‐V ECLS) showed a high incidence of vascular as well as ECLS‐related thrombotic complications. The latter may influence the outcome of the patients.MethodsThis is a retrospective monocentric study on prospectively collected data of technical complications including 69 adult COVID‐19 patients on V‐V ECLS (ECLS Registry, March 2020 until April 2021) without and with system exchanges. Alterations in ECLS‐specific data, hemolysis, coagulation, and hemostasis parameters were analyzed.ResultsEvery second COVID‐19 patient on V‐V ECLS developed technical complications. Optimized ECLS management at our ECLS center reduced cases of acute clot formation (pump head thrombosis, acute oxygenator thrombosis) (17%), and allowed early identification of progressive clotting processes (worsened gas transfer, coagulation disorder) (14%, 54%) with a significant overhang of hyperfibrinolysis (37%). Although COVID‐19 disease and technical complications caused the prolonged length of stay at the intensive care unit and ECLS support times, the proportion of successful weaning and survival rates were comparable with patients without system exchange.ConclusionThe survival of ECLS patients with COVID‐19 was independent of the requirement for system exchange due to technical‐induced coagulation disorders. Close monitoring for circuit clotting is mandatory in COVID‐19 patients and is one prerequisite for successful organ support in these difficult patients.

ПРОГНОСТИЧЕСКИЕ МАРКЕРЫ РЕСТЕНОЗА У ПАЦИЕНТОВ С ПЕРИФЕРИЧЕСКИМ АТЕРОСКЛЕРОЗОМ ПРИ ЭНДОВАСКУЛЯРНЫХ ВМЕШАТЕЛЬСТВАХ

Objective. To study the role of hemostatic parameters as potential markers of restenosis in patients with peripheral artery disease (PAD) after endovascular procedures. Methods. An open prospective study involved 55 PAD patients aged 63 (57; 69) with the stage IIb-IV Fontaine chronic lower limb ischemia; 48 (87.3%) subjects were male; 18 (32.73%) patients had type 2 diabetes mellitus (T2D). Before angioplasty or stenting of the arteries of the lower extremities, the activity of protein C (PrC), the levels of soluble endothelial receptors for protein C (sEPCR), the activity of coagulation factors FVIII, FIX, FXI were determined in the peripheral blood. Within a year every three months Duplex ultrasound or angiography for follow-up examination have been performed to detect restenosis. Results. Within one year restenosis was detected in 13 (23.6%) patients. Binary regression analysis revealed T2D, FVIII activity and sEPCR as prognostic markers of restenosis. sEPCR level lower than 46.8 ng/ml was associated with a 4.263 higher risk for restenosis after endovascular procedures (odds ratio 4.263, CI 95% 1.509-12.042); absolute risk 47±11% (CI 95% 25-69 %). The patients with T2D had a 2.6 higher risk for restenosis as compared to subjects without diabetes mellitus (odds ratio 2.6, CI 95% 1.031-6.599); absolute risk 41.18±12% (CI 95% 17.78-64.58%). The probability of developing restenosis was inversely related to the initial indicators of FVIII activity and the level of sEPCR: the lower the absolute values of FVIII and sEPCR, the higher the likelihood of developing restenosis in the postoperative period. Conclusion. Patientswith diabetes mellitus (type 2), reduced activity of coagulation factor FVIII and level of soluble endothelial protein C receptors are at particularlyhigh riskforrestenosis What this paper adds The study of hemostasis parameters in patients with the peripheral atherosclerosis revealed that the sEPCR level below 46.8 ng/ml corresponded to an elevateion of restenosis risk after endovascular interventions by 4.263 folds (odds ratio 4.263, 95% CI 1.509-12.042), the presence of type 2 diabetes mellitus - in 2.6 folds (odds ratio 2.6, 95% CI 1.031-6.599). The likelihood of developing restenosis was inversely related to baseline FVIII activity and sEPCR levels. The authors proposed a method for calculating the individual probability of developing restenosis using the abovementional indicators.

The effect of ChAdOx1 nCov-19 vaccine on arterial thrombosis development and platelet aggregation in female rats

ChAdOx1 nCoV-19 adenoviral vector vaccine (ChAd) against coronavirus disease 2019 has been associated with vaccine-induced thrombosis and thrombocytopenia (VITT), especially in young women who have presented with unusual localized thrombosis after receiving the vaccine. The pathogenesis of VITT remains incompletely understood. We tried to provide new insights into mechanisms underlying this phenomenon in the model of arterial thrombosis electrically induced in the carotid artery of female rats. At 28 days post-vaccination, ChAd induced SARS-CoV-2-specific neutralizing antibody responses in all animals. The analysis of the blood vessel/thrombus area showed slight luminal narrowing of the carotid artery with extravasation of blood in vaccinated rats. These small changes were not accompanied by differences in thrombus weight and composition. The vaccinated animals presented a slight increase (by around 14–24%) in platelet aggregation. ChAd did not significantly affect blood coagulation, platelet counts, and their activation markers. Unaffected thrombus formation, the lack of thrombocytopenia and all the measured blood and hemostasis parameters that predominantly stayed unchanged, indicate that the ChAd does not increase the risk of arterial thrombosis development in female rats.

Clinical status of patients with coronary artery disease post COVID-19

The main goal of our study was to identify the activity of cardiac dysfunction based on the analysis of the main cardiological methods of research, such as ECG, echocardiography, 24-hour ECG monitoring in conjunction with laboratory parameters in patients with coronary artery disease (CAD) who underwent mild and moderate COVID-19, without signs of residual effects of lung tissue damage (fibrotization). 52 patients with coronary artery disease were examined, which were divided into 2 groups depending on the past infection in history: 1 group without COVID-19 in history (n=26) (based on history and results of SARS-CoV-2 antibody titer), 2 a group with a history of COVID-19 (n=26), confirmed by relevant documents (tests), but without oxygen therapy and steroids, in order to avoid the influence of a serious illness and drug exposure. Conclusions: dynamic monitoring of hemostasis parameters after the hospital stage in patients with CAD should be carried out in order to prevent adverse cardiovascular outcomes, even with a history of moderate and mild coronavirus infection. One of the aspects of therapeutic rehabilitation in the post-COVID period in patients with IHD is the use of vitamin D preparations.

Inflammation and necrosis syndrome is associated with alterations in blood and metabolism in pigs

BackgroundSwine inflammation and necrosis syndrome (SINS) can lead to significant clinical alterations at tail, ears, claws and other parts of the body in suckling piglets, weaners and fatteners. Clinical findings are associated with vasculitis, intima proliferation and thrombosis. The syndrome can be found in newborns, indicating a primarily endogenous aetiology. It has been hypothesized that SINS is triggered by gut-derived microbial-associated molecular patterns, causing derangements in liver metabolism and activity of peripheral white blood cells involving inflammation and blood haemostasis. In order to characterize these metabolic derangements of SINS for the first time, red and white blood counts, parameters of blood haemostasis, serum metabolites and acute phase proteins in the serum were analysed in 360 piglets, weaners and fatteners, each with significantly different SINS scores.ResultsSINS scores and haematological/clinical chemical parameters were significantly associated (P < 0.05), especially in weaners and fatteners. Higher degrees of clinical SINS were associated with increased numbers of monocytes and neutrophils. Blood coagulation was altered in weaners and a thrombocytopenia was found in fatteners. Additionally, acute phase proteins, especially C-reactive protein and fibrinogen were increased in serum. Serum metabolites and serum liver enzymes were slightly altered. Aspartate transaminase levels overall exceeded physiological limit and increased in parallel with SINS scores in fatteners.ConclusionClinical inflammation and necrosis at tail, ears, claws and other parts of the body were significantly associated with haematology and serum clinical chemistry, especially in weaners and fatteners. The involvement of inflammatory cells, blood coagulation, acute phase proteins and certain serum metabolites support the inflammatory-necrotising character of the syndrome and provide starting points for further studies to decipher its exact pathogenesis. The low to moderate variations seem less suitable for diagnostic use.

COVID-19 как фактор риска окклюзии вен сетчатки у молодых пациентов?

Retinal vein occlusions (RVOs) are thought to have more favorable outcomes in patients under-50 due to spontaneous regression. However, 20% develop severe neovascularization. In most cases, the causal link of occlusion remains elusive. Some authors report on clinical presentations typical for RVOs in the COVID-19 infection due to hypercoagulation. Management of younger patients with RVO required a complex diagnostic approach to assess systemic risk factors and obligatory evaluation of baseline retinal ischemia using fluorescein angiography (FA) or optical coherence tomography angiography (OCTA). Clinical criteria of escalating retinal ischemia are decreased central visual acuity, macular edema, increased area of ischemia, and (later) retinal and/or anterior segment neovascularization. We describe a young man with RVO after the COVID-19 infection. The COVID-19 infection had no significant effect on hemostasis parameters in this patient. Meanwhile, the COVID-19 infection cannot be ruled out as an aggravating factor in a patient with a genetic predisposition to (micro)vascular occlusions. Keywords: OCTA, retinal neovascularization, retinal vein occlusion, coagulogram, COVID-19. For citation: Shchuko A.G., Akulenko M.V., Yur’eva T.N. COVID-19 is a risk factor for retinal vein occlusion in younger patients? Russian Journal of Clinical Ophthalmology. 2022;22(1):62–67 (in Russ.). DOI: 10.32364/2311-7729-2022-22-1-62-67.

ВЛИЯНИЕ 21-СУТОЧНОЙ АНТИОРТОСТАТИЧЕСКОЙ ГИПОКИНЕЗИИ НА СИСТЕМУ ГЕМОСТАЗА ЗДОРОВОГО ЧЕЛОВЕКА

The bed rest experiment involved 6 healthy men aged 24 to 41 years. The subjects were in the supine position for 21 days, the angle of inclination in the cranial direction was -6°. In citrated blood plasma on days 2, 5, 8 and 21 of exposure, as well as 7 days after its end, the following hemostasis parameters were determined: thrombin time, prothrombin time, activated partial thromboplastin time, fibrinogen and D-dimer concentrations, as well as activity of protein C. In comparison with background, there was slight elongation in prothrombin time on the 2nd and 5th days of the experiment, as well as on the 7th day of the recovery period, a slight shortening of the thrombin time on the 8th and 21st days of the experiment and on the 7th day of the recovery period, moderately elongated activated partial thromboplastine time on 5th and 21st day. The concentration of D-dimer was significantly reduced relative to the background in all periods of the survey, except for the 21st day, approaching the background values on the 7th day after the end of exposure. The activity of protein C did not change significantly during the entire experiment and was significantly lower than the background values only on the 7th day after the end of the experiment. The concentration of fibrinogen did not change significantly during all periods of the examination. The results of the study indicate minor changes in the parameters of the plasma component of the hemostatic system, indicating a decrease in procoagulant potential in the early stages of exposure and its increase in the later stages of hypokinesia and in the recovery period.

Effects of Carbon Monoxide on Haematological and Haemostatic Parameters among the Exposed Workers at Generator Servicing Centres in Benin City

Objectives: Carbon monoxide (CO) is an odourless and highly toxic gas produced from incomplete combustion of fuel. This gas has capacity to bind with haemoglobin to compete for oxygen uptake when inhaled, thereby altering the blood physiology. Aim: The aim of this study is to determine the effect of carbon monoxide on haematology and haemostasis parameters among the exposed workers at gasoline generators service centre in Benin City. Methodology: Eighty-eight participants (workers n = 44 and; controls n = 44) took part in this study. Carbon monoxide used for this study was sourced from the smoke being emitted by gasoline generators during repairs. The participants’ haematological parameters were analysed using haematology autoanalyzer (Sysmex Poch 100i model, Germany), while PT and PTTK were assayed using standard methods. Results: The mean values of red blood cells (RBC), white blood cells (WBC), platelets (PLT), haemoglobin concentration (Hb), hematocrit (HCT), mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell hemoglobin concentration (MCHC) and red cell distribution width coefficient variation (RDW-CV) observed in both the workers at generator service center and their controls fell within normal ranges, but the mean red cell distribution width standard deviation (RDW-SD) of workers at generator service center fell below normal as against the normal value for controls. There were no significant differences in serum concentrations of lymphocytes (p = 0.134), and granulocytes (p = 0.584). In contrast, significantly (p < 0.001) higher mean monocyte level was observed in the workers at the generator service center compared with the controls. Also, there was significantly lower mean platelet volume (MPV) (p = 0.002), platelet distribution width (PDW) (p = 0.001), platelet large cell ratio (PLCR) (p = 0.013) and higher plateletcrit (PCT) (p = 0.001) in the workers at the generator service center compared with the control group. PT and PTT values fell within normal range among the controls, while the values are higher among the exposed workers at the centres. Conclusion: In this study, carbon monoxide emitted during repairs has no deleterious effects on haematological and haemostasis parameters of the exposed workers at generator service centre in Benin City. However, PT and PTT exceeded normal value in the workers at the generator service centre compared to the controls. More work needs to be done especially on longer duration of exposure and at various concentrations of carbon monoxide exposure.