Partial Prothrombin Time Research Articles

A Retrospective Analysis of the Postoperative Effect of Intraoperative Hypothermia on Deep Vein Thrombosis After Intracranial Tumor Resection

Deep venous thrombosis (DVT) is a common clinical vascular disease, and post-thrombotic syndrome is usually the complication of patients. This study was to explore the relationship between intraoperative hypothermia and DVT. Patients who were clinically diagnosed with intracranial tumors and underwent tumors resection from January 2019 to March 2021 were studied and divided into the DVT and non-DVT group. Prothrombin time, activated partial prothrombin time (ATPP), thrombin time, plasma fibrinogen, and venous flow velocity of both lower limbs were measured to observe DVT and the incidence of DVT. Univariate and multivariate logistic regression analyses were used to investigate the correlation between intraoperative hypothermia and DVT, and to analyze the DVT-related risk factors. A total of 462 patients were analyzed, of whom 231 patients were allocated to the DVT group and 231 were in the non-DVT group. Within the DVT group, 156 patients (33.8%) experienced intraoperative hypothermia. The risk factors that were significantly correlated with DVT were age, sex, operation time, ATPP value, and intraoperative hypothermia. The decreased ATPP value was found to be significantly associated with the increased incidence of DVT, and older ages (>45 years) were highly associated with DVT. Low body temperature before operation and intraoperative hypothermia were statistically significant as well. In addition, significant association was also displayed between the patient's operation time (>350 minutes) and DVT. Patients who underwent intracranial tumor resection experience a high incidence of DVT, and patients with intraoperative hypothermia are at greater risk of DVT.

Nebulized Non-Immunogenic Staphylokinase in the Mice Acute Lung Injury Model.

Acute lung injury (ALI) as a model of acute respiratory distress syndrome is characterized by inflammation, complex coagulation, and hematologic abnormalities which result in the formation of fibrin-platelet microthrombi in the pulmonary vessels with the rapid development of progressive respiratory dysfunction. We hypothesize that a nebulized fibrinolytic agent, non-immunogenic staphylokinase (nSta), may be useful for ALI therapy. First, the effect of the nebulized nSta (0.2 mg/kg, 1.0 mg/kg, or 2.0 mg/kg) on the coagulogram parameters was studied in healthy rats. ALI was induced in mice by nebulized administration of lipopolysaccharide (LPS) at a dose of 10 mg/kg. nSta (0.2 mg/kg, 0.4 mg/kg or 0.6 mg/kg) was nebulized 30 min, 24 h, and 48 h after LPS administration. The level of pro-inflammatory cytokines was determined in the blood on the 8th day after LPS and nSta administration. The assessment of lung damage was based on their weighing and microscopic analysis. Fibrin/fibrinogen deposition in the lungs was determined by immunohistochemistry. After nSta nebulization in healthy rats, the fibrinogen blood level as well as activated partial thromboplastin time and prothrombin time did not change. In the nebulized ALI model, the mice showed an increase in lung weight due to their edema and rising fibrin deposition. An imbalance of proinflammatory cytokines was also found. Forty percent of mice with ALI without nSta nebulization had died. Nebulized nSta at a dose of 0.2 mg/kg reduced the severity of ALI: a decrease in interstitial edema and inflammatory infiltration was noted. At a dose of 0.4 mg/kg of nebulized nSta, the animals showed no peribronchial edema and the bronchi had an open clear lumen. At a dose of 0.6 mg/kg of nebulized nSta, the manifestations of ALI were completely eliminated. A significant dose-dependent reduction of the fibrin-positive areas in the lungs of mice with ALI was established. Nebulized nSta had a normalizing effect on the proinflammatory cytokines in blood— interleukin (IL)-1α, IL-17A, IL-6, and granulocyte-macrophage colony-stimulating factor (GM-CSF). These data showed the effectiveness of nebulized nSta and the perspectives of its clinical usage in COVID-19 patients with acute respiratory distress syndrome (ARDS).

Antioxidant, anticoagulant and thrombolytic properties of SIP-IV, a sulfated polysaccharide from Sepia esculenta ink, and its derivatives

Carboxymethylated, phosphorylated and sulfated derivatives of SIP-IV, a polysaccharide derived from Sepia esculenta ink, were prepared and their antioxidant, anticoagulant and thrombolytic properties were evaluated. Data showed that sulfation and phosphorylation modification improved antioxidant activity of SIP-IV, but carboxymethylation impaired the property. In vitro data showed that SIP-IV and its three modified derivatives could significantly prolong activated partial thrombin time (APTT), prothrombin time (PT) and thrombin time (TT), and also exhibited thrombolysis activity. In vivo, these polymers alleviated chemotherapy-induced blood hypercoagulation by reversing abnormal levels of coagulation factors II and X, and antithrombin III in plasma, resulting in prolonged bleeding time. Moreover, the polysaccharides play an antagonistic role against chemotherapy-mediated liver oxidative stress. Sulfate-modified polysaccharide (S-SIP-IV) has the best anticoagulant, thrombolytic and antioxidant effects.

Doenitin-1: A novel Kunitz family protein with versatile functions during feeding and reproduction of the tick Haemaphysalis doenitzi.

As obligate blood-feeding ectoparasites, ticks secrete a great diversity of antithrombin molecules during feeding. In this study, a novel antithrombin gene named Doenitin-1 was characterized from the tick Haemaphysalis doenitzi. It has an open reading frame size of 426 bp; it encodes 141 amino acids and has a predicted molecular weight of 15.8 kDa. The fibrinogen coagulation test showed that the time of coagulation was increased significantly with increase in rDoenitin-1 protein concentration, and the activated partial thromboplastin time (APTT) and prothrombin time (PT) assays showed that rDoenitin-1 significantly prolonged the coagulation time of APTT, indicating that rDoenitin-1 has an anticoagulant activity in vitro. In addition, rDoenitin-1 presents a significant inhibitory activity in thrombin and cathepsin G. The hemolysis rate of rDoenitin-1 in healthy human blood cells was 4.25%, and no obvious hemolysis activity was observed. The comparison with other life stages shows that the higher expression occurs in adults, and tissue comparison indicated a higher expression in the midgut. The RNAi results indicated that interference of Doenitin-1 significantly reduced the engorgement rate and egg hatchability of H. doenitzi, and that the engorged body weight was slightly reduced. In conclusion, the results suggested that the novel gene Doenitin-1 functions in blood-feeding of H. doenitzi and performs various functions during feeding and reproduction of H. doenitzi. Doenitin-1 may be a potential vaccine candidate for tick control and for developing new antithrombotic drugs in the future.

In vitro assessment of the bioactive potential of Artemisia campestris L. fractions growing in Khenchela (Algeria)

In order to valorize Algerian medicinal plants, this work aims to characterize quantitatively and qualitatively Artemisia campestris L. fractions, a medicinal plant from the Aures-Algeria area, and investigate its biological activities in vitro. During preliminary phytochemical screening, flavonoids, saponins, tannins, alkaloids, reducing compounds, and coumarins were discovered. Total polyphenols and flavonoids are greater in the n-butanolic fraction than in ethyl acetate and petroleum ether. The resulting antioxidant capability was assessed in vitro using three methods: DPPH free radical scavenging, hydrogen peroxide trapping, and iron reduction. The n-butanolic extract suppresses DPPH oxidation with an IC50 of 2.239±0.32mg/ml, which is comparable to that of standard (1.824±0.97mg/ml). Despite the fact that similar findings were seen in the neutralization of hydrogen peroxide and the iron chelating activity, The anti-inflammatory action was proven in vitro by inhibiting protein denaturation and increasing HRBC membrane stability (Human Red Blood Cells). The n-butanolic fraction was more effective than diclofenac in preventing BSA degradation. It also inhibited membrane hemolysis in human erythrocytes by up to 83%. Activated partial thromboplastin and prothrombin times were used to analyze extrinsic and intrinsic coagulation pathways in A. campestris in order to determine its anticoagulant activity. The n-butanol fraction had the greatest impact on PT and aPTT lengthening, with 75.2s and 351s at 3 mg/ml concentration, respectively. The n-butanolic fraction of the A. campestris aerial part exhibited antioxidant, anti-inflammatory, and anticoagulant activities. As a result, it may be a viable natural resource for mitigating the impact of stress, which causes inflammatory and cardiovascular disorders.

Preparation and blood compatibility of polyethersulfone dialysis membrane modified by apixaban as coagulation factor Xa inhibitor.

Blood purification therapy is widely used in the treatment of critically ill patients. However, most dialysis membranes are prone to thrombosis. Activated coagulation factor X (FXa) functions at the intersection of intrinsic, extrinsic, and common coagulation pathways and plays a central role in thrombogenesis. To date, few dialysis membranes that directly inhibit FXa have been reported. We modified a polyethersulfone(PES) membrane using apixaban as an FXa inhibitor and investigated the performance of this membrane (AMPES). The contact angle of the modified membrane was reduced. PWF and retention rates of BSA were increased, demonstrating good hydrophilicity and dialysis performance. Albumin adsorption was reduced from 141.8±15.5 to 114.1±6.9μgcm-2. Reduced protein adsorption, especially targeted anti-FXa effect, inhibited the activation of intrinsic, extrinsic, and common coagulation pathways, as evidenced by significant prolongations of activated partial thromboplastin time, prothrombin time, and thrombin time by 145.04, 46.84 and 11.46s, respectively. Furthermore, we determined the FXa concentration of each group, and found that the modified membrane had better anticoagulant performance through the inhibition of FXa. Favorable antiplatelet activity was also demonstrated. Thromboelastogram was used to comprehensively evaluate the anticoagulant and antithrombotic activities of the modified membrane. The R value was increased by 43.1min, while the reduction in α angle was 42.5°. The coagulation comprehensive index reduction was 34.3. In addition, C3a and C5a were decreased by 15.3% and 30.4%, respectively. Furthermore, in vitro cytotoxicity and erythrocyte stability testing as well as in vivo murine experiments demonstrated the biosafety of the modified membrane. These results indicate that the AMPES dialysis membrane has an excellent potential for clinical applications.

A Novel Polysaccharide from AuriculariaAuricula Alleviates Thrombosis Induced by Carrageenan in Mice.

The increasing incidence of cardiovascular diseases has created an urgent need for safe and effective antithrombotic agents. In this study, we aimed to elucidate the structural characteristics and antithrombotic activity of a novel polysaccharide isolated from Auricularia auricula fruiting bodies. The purified polysaccharide AAP-b2 (12.02 kDa) was composed of mannose, glucuronic acid, glucose and xylose, with a molar ratio of 89.25:30.50:4.25:1.00. Methylation and NMR analyses showed that AAP-b2 primarily consisted of →2,3)-Manp-(1→, →3)-Manp-(1→, →4)-GlcAp-(1→ and Manp-(1→. A thrombus mouse model induced by carrageenan was used in this research to evaluate its antithrombotic effect. AAP-b2 significantly inhibited platelet aggregation, reduced the black tail length and prolonged the coagulation time, including activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT), exerting a good inhibitory effect on thrombosis in mice. The antithrombotic activity of AAP-b2 was found to be related to the inhibition of platelet activation by regulation of endothelial nitric oxide synthases (eNOs), endothelin-1 (ET-1), prostacyclin (PGI2) and thromboxane B2 (TXB2), along with the enhancement of anticoagulant activity by affecting antithrombin III (AT-III) and protein C (PC) pathways.

Anemia-Associated Platelets and Plasma Prothrombin Time Increase in Patients with Adenomyosis.

Patients with adenomyosis are hypercoagulable and often accompanied by anemia, but the specific changes in anemia-related coagulation parameters are still unclear. This study investigated the changes in and influencing factors of coagulation parameters related to anemia in patients with adenomyosis (AM). The coagulation parameters, including platelet count (PC), plasma prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (FB), and hemoglobin (Hb), were measured in patients with adenomyosis (229 cases in AM group), uterine leiomyoma (265 cases in LM group), and undergoing tubal anastomosis (142 cases in the control group). The age of the control group was younger than that of the AM group and the LM group. Compared with the AM and LM groups, the uterus size of the control group was smaller; the AM group was larger than the LM group. The Hb concentration of the AM group was lower than that of the LM and control groups. Compared with the LM and control groups, PC increased and TT shortened in the AM group. APTT in the AM group was shorter than in the control group, and PT was longer than in the LM group. After adjustment using multiple logistic regression analysis, adenomyosis was correlated with Hb concentration (or = 0.971, 95% CI 0.954–0.988, p < 0.001), PC (or = 1.006, 95% CI 1.002–1.011, p = 0.004), PT (or = 3.878, 95% CI 2.347–6.409, p < 0.001), age (or = 1.062, 95% CI 1.013–1.114, p = 0.013), and uterine size (or = 1.103, 95% CI 1.011–1.203, p = 0.028). Correlation analysis showed that PC (r = −0.309) and PT (r = −0.252) were negatively correlated with anemia. The increase in Hb-related PC and PT in patients with adenomyosis indicates that the timely and early detection of coagulation parameters is needed for patients with severe anemia, older age, and larger uterine volume.

Influence of ABO blood group antigen on activated partial thromboplastin and prothrombin time tests in healthy university students kosti city, White Nile state, Sudan

Background: Variances in blood group antigen have been related with susceptibility particular to diseases. Prothrombin time [PT], measures the efficiency of the extrinsic and common coagulation pathways, although Activated partial Thromboplastin time [APTT] test evaluates the intrinsic and common coagulation pathways. Objective: To explore the influence of blood groups antigen on APTT and PT among Healthy University Students on different ABO blood groups. Materials and methods: Cross section study including student during the period of three months from September 2020 to December 2020 at Medical campus, University of El Imam El Mahdi, White Nile State, Kosti City, total of 480 students were enrolled. Four milliliters of venous blood was collected from each student, ABO blood grouping was done by the tile method whereas APTT, and PT were analyzed using the manual methods. Data were processed using the Statistical Package for the Social Sciences (SPSS) program version 26 by means of descriptive and inferential statistics. Results: Blood group O was largest among the test individuals [45%], followed by blood group A [30%] and B [16%], while blood group AB has the smallest percentage of (9%). Blood group O is significantly higher APTT value [39.07 ± 4.81] second compared to blood groups A [36.60 ± 5.89] second, AB [35.23 ± 4.86] second, and B [34.39 ± 5.30] second, P value &lt; 0.05. Likewise, blood group A showed a significantly higher PT value [15.94 ± 1.36] second compared to blood groups O [14.12 ± 1.43] second, B [13.54 ± 1.35] second, and AB [14.67 ± 1.80] second, P &lt; 0.05. Male had a higher APTT level (44.44± 7.27] second, PT [15.66 ± 1.88] second, and, compared with the female APTT [35.14 ± 6.49] second, PT [14.08 ± 1.29] second, P value &lt; 0.05. Conclusion: Males have a higher APTT and PT levels compared to females. Blood group [O] individuals having a significantly higher APTT, while blood group [A]individuals having higher PT. This proposal that blood group of individuals may be affect their intrinsic (APTT) and extrinsic Coagulation mechanisms (PT].

Study on the antithrombotic effect and physiological mechanism of okanin

The objectives of this study were to investigate the antithrombotic effect and physiological mechanism of okanin, a flavonoid monomer in Coreopsis tinctoria Nutt. The antithrombotic effects of okanin were determined by the anticoagulant activity test in vitro and in vivo, the venous thrombosis and arterial thrombosis test in rats. To study the antithrombotic physiological mechanisms of okanin, UV spectrophotometer and enzyme-linked immunosorbent assay (ELISA) were used to determine the effects of three concentrations of okanin on the contents of 6-keto-prostaglandin F1α (6-Keto-PGF1α), thromboxane B2 (TXB2), endothelin-1 (ET-1), antithrombin III (AT-Ⅲ), protein C (PC) and von willebrand factor (vWF) in the plasma of rats with arterial thrombosis; ELISA was used to detect the effects of okanin on the contents of plasminogen (PLG), tissue plasminogen activator (t-PA) and type-1 plasminogen activator inhibitor (PAI-1) in the plasma of mice and Chinese white rabbits. The results showed that okanin could prolong the coagulation time in vitro and in vivo of animals (P < 0.01 in the high dose group) and the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) of human venous blood (ATPP of medium dose group P < 0.01; PT, TT P < 0.05. P < 0.01 in the high dose group); inhibit the maximum platelet aggregation rate of rabbits (P < 0.05 in the low dose group; P < 0.01 in the medium and high dose groups), decrease the dry and wet weight of venous thrombosis and the wet weight of common carotid artery thrombosis in rats (low dose group, P < 0.05; medium and high dose groups, P < 0.01); increase the levels of 6-Keto-PGF1α, AT-Ⅲ, PLG and t-PA in animal plasma; decrease the levels of TXB2, ET-1, vWF and PAI-1 in animal plasma. It is concluded that okanin can significantly inhibit thrombosis, and its physiological mechanisms were related to affecting the activation of related coagulation factors in endogenous and exogenous coagulation pathways, affecting the physiological characteristics of platelets, repairing damaged vascular endothelial cells and enhancing the activity of the fibrinolytic system.

The antiplatelet activity of camel milk in healthy and aluminum chloride-intoxicated rats

This study examined the effect of camel milk on some marker of blood coagulation markers in aluminum chloride (ALCl3)-treated rats. Rats (n = 6) were assigned as control, control + fresh camel milk (1 ml), ALCl3 (0.5 mg/kg), and ALCl3 + fresh camel milk (1 ml and 0.5 mg/kg, respectively). Treatments were conducted orally for 30 days and daily. Administration of camel milk to control and ALCl3-intoxicated rats significantly increased platelet count, bleeding time, and collagen epinephrine (CEPI)-induced platelet aggregation. It also lowered plasma levels of thromboxane B2 and hepatic levels of glutathione (GSH) and the activities of antioxidant enzymes, catalase (CAT) and superoxide dismutase (SOD). While the treatment with camel milk has no effect on the liver structure, values of activated partial prothrombin time (aPPT), and levels of prothrombin time (PT) in control rats, it improved liver architectures and decreased serum levels alanine and aspartate aminotransferases (ALT and AST, respectively), and reduced values of both aPTT and PT in ALCl3-intoxicated rats. In conclusion, camel milk inhibits platelets activity and aggregation in both control and ALCl3-intoxicated rats.

Modern possibilities and prospects in evaluating the anticoagulant effect of direct oral anticoagulants

Currently, direct oral anticoagulants (DOACs) should be preferred when prescribing anticoagulant therapy to atrial fibrillation patients because of their lower potential for interactions and risk of bleeding than warfarin. However, in the absence of standardized laboratory tests and a specific antidote (except dabigatran), prescribing and monitoring DOAC therapy remains a challenge for clinicians and patients. The present review focuses on the problems of DOAC laboratory evaluation, indications, and prospects for its use. Routine coagulation tests including activated partial thromboplastin time, prothrombin time and thrombin time are not recommended for DOAC therapy. Currently, there are specific coagulation tests (anti-Xa activity factor determination for apixaban/ rivaroxaban and diluted thrombin time for dabigatran) that allow judging the presence of the drug in the blood. According to current recommendations, these tests should be used only to assess anticoagulant concentrations and not to adjust doses and decide on the timing of withdrawal before invasive intervention. Nevertheless, the issue of determining DOAC concentration during invasive interventions, the need for which only increases with age, is most relevant. Also a possible additional factor that may alter the bioavailability and pharmacokinetics of DOAC and be taken into account in the evaluation of laboratory activity is the presence of chronic renal disease, hepatic insufficiency, low or excess body weight. The use of specific coagulation tests for patients undergoing elective and urgent surgery among special categories of patients (with chronic kidney disease, low or excess body weight, renal failure) is promising.

Antithrombotic and antihemolytic effects of Lagerstroemia speciosa (Lythraceae) aqueous extract

Introduction: Aqueous extract of Lagerstroemia speciosa (EALS) (Lythraceae) is widely used to treat diabetes. This plant has been shown an in vitro thrombolytic activity that indicates its potential to prevent the formation of blood clots in vivo. Thus, this study was undertaken to evaluate the antithrombotic and antihemolytic effects of EALS. Methods: Rats of both sexes (200 ± 5 g) were divided into five groups of six animals. Each group received orally distilled water, EALS (250, 500, 1000 mg/kg), and acetylsalicylic acid (100 mg/kg) for five days. After treatment, the FeCl3-induced arterial thrombus formation method was used to determine occlusion time. A coagulometer was used to detect activated partial thromboplastin time (aPTT) and prothrombin time (PT). Rabbit blood was used to determine clot lysis activity in vitro and antihemolytic activity using the 2,2-azobis hydrochloride (2-methylpropionamidine) (AAPH) method. Results: EALS increased the occlusion time in a dose-dependent manner. At the dose of 1000 mg/kg, EALS increased the occlusion time significantly, from 4.59 ± 2.45 minutes to 15.52 ± 2.38 minutes (P&lt;0.01). At high concentrations (1-4 mg/mL), EALS showed a significant increase in aPPT and PT (P&lt;0.05). Streptokinase and EALS (4 mg/mL) induced significant clot lysis with percentage values of 78.48 ± 2.2 % and 49.5 ± 1.53 %, respectively (P&lt;0.001). EALS inhibited AAPH-induced hemolysis. Conclusion: EALS exhibited antithrombotic and antihemolytic activities. The antithrombotic property of the plant could be attributed to its anticoagulant and thrombolytic activities. Regular consumption of L. speciosa leaves may prevent or treat thrombotic diseases.

Diagnosis and Prognosis of COVID-19 Disease Using Routine Blood Values and LogNNet Neural Network.

Since February 2020, the world has been engaged in an intense struggle with the COVID-19 disease, and health systems have come under tragic pressure as the disease turned into a pandemic. The aim of this study is to obtain the most effective routine blood values (RBV) in the diagnosis and prognosis of COVID-19 using a backward feature elimination algorithm for the LogNNet reservoir neural network. The first dataset in the study consists of a total of 5296 patients with the same number of negative and positive COVID-19 tests. The LogNNet-model achieved the accuracy rate of 99.5% in the diagnosis of the disease with 46 features and the accuracy of 99.17% with only mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and activated partial prothrombin time. The second dataset consists of a total of 3899 patients with a diagnosis of COVID-19 who were treated in hospital, of which 203 were severe patients and 3696 were mild patients. The model reached the accuracy rate of 94.4% in determining the prognosis of the disease with 48 features and the accuracy of 82.7% with only erythrocyte sedimentation rate, neutrophil count, and C reactive protein features. Our method will reduce the negative pressures on the health sector and help doctors to understand the pathogenesis of COVID-19 using the key features. The method is promising to create mobile health monitoring systems in the Internet of Things.

Association of FXI activity with thrombo-inflammation, extracellular matrix, lipid metabolism and apoptosis in venous thrombosis

Animal experiments and early phase human trials suggest that inhibition of factor XIa (FXIa) safely prevents venous thromboembolism (VTE), and specific murine models of sepsis have shown potential efficacy in alleviating cytokine storm. These latter findings support the role of FXI beyond coagulation. Here, we combine targeted proteomics, machine learning and bioinformatics, to discover associations between FXI activity (FXI:C) and the plasma protein profile of patients with VTE. FXI:C was measured with a modified activated partial prothrombin time (APTT) clotting time assay. Proximity extension assay-based protein profiling was performed on plasma collected from subjects from the Genotyping and Molecular Phenotyping of Venous Thromboembolism (GMP-VTE) Project, collected during an acute VTE event (n = 549) and 12-months after (n = 187). Among 444 proteins investigated, N = 21 and N = 66 were associated with FXI:C during the acute VTE event and at 12 months follow-up, respectively. Seven proteins were identified as FXI:C-associated at both time points. These FXI-related proteins were enriched in immune pathways related to causes of thrombo-inflammation, extracellular matrix interaction, lipid metabolism, and apoptosis. The results of this study offer important new avenues for future research into the multiple properties of FXI, which are of high clinical interest given the current development of FXI inhibitors.

Potential Anticoagulant Activity of Thymus atlanticus Leaves Part in vitro on Normal Plasma Samples

The purpose of this study was to evaluate the anticoagulant activity of Thymus atlanticus leaves. Methods and Results: This cross-sectional study was carried out in Khartoum state from March 2021 to June 2021. This study comprised 60 healthy volunteers (40% men and 60% women) aged 19-25 years. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were evaluated in the blood plasma with different amounts of Thymus atlanticus leaves using Coatron M1 (TECO Medical Devices). Thymus atlanticus leaves considerably lengthened APTT and PT in all tested concentrations. Furthermore, only the APTT test at a concentration of 5.17 μl revealed a significant difference in the anticoagulant activity of Thymus atlanticus leaves between males and females. No correlation between age and anticoagulant activity of Thymus atlanticus leaves on PT and APTT in the study was found.

Thromboembolic disorder in a dog after cesarean surgery

A 3-year female dog (intact primiparous) overweight Labrador Retriever was presented as an emergency (fever, lethargy, and anorexia)patient. Four days earlier, this dog had a dystocia (secondary uterine inertia with stillborn fetus) that was relieved via cesareansurgery. Disseminated intravascular coagulation panel indicated marked increases in D-dimers, increases in partial prothrombintime, and decreases in antithrombin III activity. Abdominal ultrasonography revealed a severely mottled spleen with multifocalinfarction. Arterial blood gas analysis indicated increases in alveolar-arterial oxygen gradient. Pulmonary thromboembolism wassuspected. Based on the history (peripartum obesity and cesarean delivery) and clinical manifestation, it was hypothesized that thepregnancy-related hypercoagulable state and postpartum period led to the development of venous thromboembolism. To authors’knowledge, this is the first case report of a suspected thromboembolic disorder in a postcesarean dog.

Some Haemostatic Indices and Body Mass Index of Apparently Healthy Deskbound and Non-Deskbound Employees of a Tertiary Institution in Port Harcourt, Nigeria

Background: Prothrombin time (PT) and international normalized ratio (INR) is typically used in conjunction with activated partial thromboplastin time (APTT) to evaluate the overall integrity of the intrinsic, extrinsic and common coagulation pathway and to monitor the treatment of coagulation disorders while BMI screens for weight categories ;an important health index. A high BMI can indicate high body fatness while a low BMI connotes risks of being underweight. These extremes have obvious health challenges. The aim of the study is to determine some haemostatic indices and body mass index in apparently healthy deskbound and non-deskbound employees of the Rivers State University, Port Harcourt. Methods: A total of hundred (100) employees of the Rivers State University were recruited for this study comprising of 37 females and 63 males, out of which 53 were non-deskbound and 47 deskbound. The deskbound employees were those that work for an average of seven hours sitting down at a stretch while the non-deskbound work for an average of less than seven hours sitting down at a stretch. Using a structured questionnaire, demographic information was collected from each participant. The weight and blood pressure (BP) of each participant was taken using a weighing scale and a MOTECH digital BP monitor respectively. A standard venipuncture technique was used to collect 3ml of blood into 3.2% tri-sodium citrate anticoagulant (at the ratio of 9:1 blood-anticoagulant) for analysis. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were analyzed using the Helena C4 semi-automated coagulation analyzer, photo-optical coagulation analyzer and the Agape test kit manufactured by Agape diagnostics Switzerland. International normalized ratio (INR) was calculated from the PT results. The data obtained was analyzed using Graphpad Prism software version 6.00 produced by Graphpad software Inc. USA. Data was presented as means, median, range and standard deviation. Comparison between two means was done using student t-test analysis. Results: The mean ± SD of the PT, INR, APTT and BMI were 13.21 ± 1.97s, 1.03 ± 0.15, 29.7 ± 4.90s and 27.02 ± 2.95s in the same order and the reference ranges established for both deskbound and non-deskbound employees as the following values: PT (s): 9.27-17.15, APTT (s): 19.9-39.5 and INR: 0.73-1.33. Comparison of the prothrombin time (PT), international normalized ratio (INR), activated thromboplastin time (APTT) and BMI between non-deskbound and deskbound staff showed a statistical significant difference for APTT (P=0.0119) and BMI (P=0.0427) while the PT and INR showed no significant statistical difference. However, all the measured haemostatic parameters were within the reference ranges. Conclusion: The increased APTT observed among the deskbound employees is a pointer to an abnormal haemorrhage if their sedentary working lifestyle continues without any ameliorative measures. Also the increased BMI seen among the Deskbound employees connotes overweight and its attendant health consequences. It is therefore recommended that the deskbound employees should make it a point of duty to walk around in-between their working schedules to break the long hours of sitting down.

B cell subsets were associated with prognosis in elderly patients with community acquired pneumonia

BackgroundThe role of B cell subsets remained to be elucidated in a variety of immune diseases, though which was used as an effective biomarker for anti-inflammatory or antiviral response. This study aimed to evaluate the early changes of B cell subtypes distribution in elderly patients with community acquired pneumonia (CAP), as well as the association between B cell subtypes and prognosis.MethodsThis prospective study included elderly patients with CAP, severe CAP (sCAP) and healthy elderly subjects between April 2016 and March 2018. Flow cytometry was used to detect CD3, CD20, HLA-DR, CD24, CD27, CD38, IgM, and IgD. CD20+ B cells were further divided into naïve B cells (Bn), IgM/D+ memory B cells (IgM+ Bm), switched B cells (SwB), and transitional B cells (Btr).ResultsA total of 22 healthy controls, 87 patients with CAP and 58 patients with sCAP were included in the study. Compared to CAP, sCAP was characterized by significantly lower absolute number of B cells, Bn and Btr, significantly lower Btr and Bn subset percentage, while percentage of IgM+ Bm was significantly higher. Heat map showed Bn and Btr on day 3 and day 7 was negatively correlated with activated partial prothrombin time (APTT), international normalized ratio (INR), sequential organ failure assessment score (SOFA) and Acute Physiology and Chronic Health Evaluation II (APACHE II). After 28-day follow-up, Btr percentage in survival group was significantly higher. Receiver operator characteristic (ROC) curve analysis found that Btr count showed sensitivity of 48.6% and specificity of 87.0% for predicting the 28-day survival, with an area under the ROC curves of 0.689 (p = 0.019).ConclusionsSeverity and prognosis of CAP in elderly people is accompanied by changes in the B cell subsets. Btr subsets could play prognostic role for a short-term mortality of elderly CAP patients.

A look into hemostatic characteristics during pediatric liver transplantation using the thromboelastometry (ROTEM® ) test.

There is a paucity of evidence about the coagulation profile regarding the complexity of children undergoing liver transplantation (LT). This study aimed to investigate intraoperative hemostatic changes during pediatric LT according to the etiology for LT and examine the ability of rotational thromboelastometry (ROTEM® , TEM International GmbH, Munich, Germany) as a point-of-care monitoring method. We evaluated 106 patients aged 3months to 17years undergoing LT for acute liver failure (ALF) and chronic liver disease, which consists of patients with cholestatic disease, metabolic/genetic disease, and cancer. A total of 731 ROTEM® measurements, including 301 ellagic acid to initiate clotting via the intrinsic pathway, 172 tissue factor to initiate the extrinsic clotting cascade (EXTEM), and 258 cytochalasin D to inhibit platelet activity reflecting fibrinogen (FIBTEM), were analyzed at predetermined time points (the preanhepatic, anhepatic, and postreperfusion phases). We simultaneously conducted conventional coagulation tests. In children with ALF, preanhepatic measurements of conventional coagulation tests and ROTEM® showed a more hypocoagulable state than other diseases. During LT, the coagulation profile was deranged, with a prolonged clotting time and reduced clot firmness, changes that were more profound in the cholestatic disease group. Maximum clot firmness (MCF) on EXTEM and FIBTEM were well correlated with the platelet count and fibrinogen concentration (r=0.830, p<0.001 and r=0.739, p<0.001, respectively). On the EXTEM, MCF with 30mm predicted a platelet count <30,000/mm3 (area under the curve, 0.985), and 6mm predicted a fibrinogen concentration <100mg/dl on the FIBTEM (area under the curve, 0.876). However, the activated partial thromboplastin time and prothrombin time were significant but only weakly correlated with the clotting time on the ROTEM® . In children undergoing LT, coagulation profiles depend on the etiology for LT. During LT, ROTEM® parameters could help detect thrombocytopenia and hypofibrinogenemia and guide transfusion therapy as a point-of-care monitoring method.