Soluble Fibrin Monomer Complexes Research Articles

COAGULATION AND ANTICOAGULATION PARAMETERS IN MULTIPLE SCLEROSIS PATIENTS WITH AND WITHOUT COVID-19

The aim. To investigate plasma levels of main coagulation and fibrinolytic factors in MS patients with and without COVID-19 history. Materials and methods. A total of 127 participants were enrolled in this study, including 97 MS patients and 30 healthy controls (HC). Patients with MS were divided into two groups: MS+Covid group (n=41) – patients with MS, who had a laboratory-verified diagnosis of COVID-19 in the past 3-6-month period and MS group (n=56) – patients with MS, who did not suffer from COVID-19 previously. Determination of plasma levels of prothrombin, plasminogen, tissue-type plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1), protein C (PC), soluble thrombomodulin (TM) was performed by means of enzyme-linked immunosorbent assay. Spectrophotometric techniques were used to determine concentrations of fibrinogen, soluble fibrin monomeric complexes (SFMC) as well as plasminogen activity and inhibitory potential of α-2-antiplasmin. Results. The MS group was characterized by elevated levels of plasma prothrombin, fibrinogen, D-dimer, SFMC, soluble TM compared to HC, while PC concentration did not differ between MS and HC groups. Plasma plasminogen level as well as plasma level of the potential plasmin activity were significantly decreased in MS patients compared to HC group. The plasma tPA level was significantly reduced while plasma PAI-I level was significantly increased in MS patients compared to HC. Patients of MS group had an increased level of plasma α-2-antiplasmin activity compared with HC group. To note, most of studied parameters did not differ between two MS groups, except protein C, soluble thrombomodulin levels and plasma α-2-antiplasmin activity. Conclusions. The results of our study showed that MS patients have got altered hemostasis parameters; however, further study is necessary to find out the relationship between particular components of coagulation and fibrinolytic systems and pathophysiology of MS. Additionally, our findings demonstrated that a SARS-CoV-2 infection had a limited effect on hemostasis parameters in MS patients, causing changes in only a few parameters, including thrombomodulin and protein C levels as well as α-2-antiplasmin activity.

Characteristics of fibrin/fibrinogen degradation products in multiple sclerosis following SARS-CoV-2 infection

Background. The purpose of this study was to investigate plasma levels of fibrinogen and products of its degradation in patients with multiple sclerosis (MS) with and without a history of coronavirus disease 2019 (COVID-19). Materials and methods. We examined 97 patients with MS. Based on the presence of COVID-19, all cases were divided into two groups. MS group included 56 patients who did not suffer from COVID-19 previously. MS + COVID group consisted of 41 cases who had a laboratory-verified diagnosis of COVID-19. The group of healthy controls included 30 healthy volunteers. Spectrophotometric techniques were used to measure the concentrations of fibrinogen, D-dimer, and soluble fibrin monomer complexes (SFMCs). Size-exclusion chromatography was applied to analyze the composition of SFMC fractions. Results. We found that concentrations of fibrinogen, D-dimer, and SFMCs were remarkably increased in plasma of all MS patients compared with healthy controls. The levels of D-dimer, and SFMCs did not differ between two MS groups, while plasma fibrinogen concentration was significantly increased in MS + COVID patients compared to MS group. Moreover, the development of MS was accompanied by the changes in both quantity and quality of SFMC composition compared to that of healthy controls. Our results demonstrated accumulation of high-molecular-weight SFMCs in plasma of MS patients. Conclusions. The findings indicated that MS patients had changed hemostasis characteristics; however, more research is required to determine the connection between particular hemostatic factors, namely fibrinogen, D-dimer, and SFMCs, and the pathophysiology of MS.

Erythema nodosum in children

Erythema nodosum, which is often associated with infectious diseases, is one of the rare skin manifestations in the practice of pediatricians and pediatric infectious disease specialists. Purpose. The purpose was to study the clinical and laboratory manifestations of erythema nodosum in children. Material and methods. The study included 17 children with erythema nodosum aged 2 to 17 years who were hospitalized at the City Children’s Hospital No. 1 of Kazan. Results. In 6 (35 %) children, elevated values of antistreptolysin-O were detected, in 5 (29 %) — high titers of antibodies to Salmonella, in 2 (12 %) cases — IgM to Chlamidia pneumonia, in 2 (12 %) other children — IgM to capsid antigen of EBV, in one case (6 %) — IgM to Mycoplasma pneumonia. Increased erythrocyte sedimentation rate and C-reactive protein level was observed in 15 (88 %) and 12 (70 %) children, respectively. In 12 (70 %) of 17 children, increased level of soluble fibrin-monomer complex was detected in the blood. Conclusion. Erythema nodosum in children in most cases is associated with streptococcal infection and salmonellosis. The immune-inflammatory process in erythema nodosum is accompanied with an increase in the level of soluble fibrin-monomer complex in the blood.

Features of the systemic influence of cervical cancer on peripheral blood and hemostasis according to the tumor histological subtype

Aim. To identify the features of the systemic effect on hematopoiesis and the blood coagulation system of different histological subtypes of cervical cancer (CC).Materials and methods. A single-center retrospective cohort study of 428 patients (61 patients with high grade squamous intraepithelial lesion (carcinoma in situ) and 367 patients with CC) examined from 1997 to 2022 in the Polyclinic of P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia. The age of patients was from 18 to 90 years (median age – 42 [34; 51] years). Patients were divided into 4 groups: group 1 – patients with high grade squamous intraepithelial lesion and 3 groups depending on tumor’s histological subtype (squamous cell, glandular squamous cell, adenocarcinoma). Demographic and clinical data were analyzed including laboratory tests (general blood count, biochemical blood test and iron metabolism and coagulograms (total 32 variables)) compared to clinical and surgical stages of CC.Results. High grade squamous intraepithelial lesion does not have a systemic effect on the parameters of general, biochemical blood tests and hemostasis (p >0.05). On the other hand, statistically significant changes were found in the parameters of routine laboratory blood tests, which correlate with the results of microinvasive analysis of CC, thus revealing the systemic effect of a malignant tumor: at p ≤0.001 for thrombin time, total protein, alkaline phosphatase levels; at p ≤0.05 for alanine aminotransferase, aspartate aminotransferase, C-reactive protein, serum iron and urea levels. Among patients with CC, statistically significant (p<0.001) correlations were obtained between hematological, hemostasiological and biochemical blood parameters. Of statistical significance, the presence of the glandular component in the tumor increases the systemic effect of CC on blood parameters, hemostasis, markers of inflammation and iron metabolism: leukocytosis and maximum erythrocyte sedimentation rate values compared to CC, high fibrinogen and the level of soluble fibrin-monomer complexes which increased activation of coagulation hemostasis along the common coagulation pathway (thrombin time) (p<0.001). It leads to an increase in the risk of venous thromboembolic complications in this category of patients.Conclusion. The identified changes in blood parameters made it possible to reveal the unique biological characteristics of each histological subtype of CC, including biochemical ones, which will help in developing an improved diagnosis of CC depending on the histological subtype and stage of the disease, along with developing preventive measures and treatment methods adapted to each specific case.

CHANGES IN INDICATORS OF THE COAGULATION SYSTEM AND MARKERS OF INFLAMMATION IN THE BLOOD OF PATIENTS WITH DEGENERATIVE DISEASES OF LARGE JOINTS IN THE CASE OF TOTAL ARTHROPLASTY

Predicting the risk of developing thrombotic complications is an extremely important task when planning total arthroplasty of large joints (TAJ). Objective. Based on the retrospective analysis of the results of the biochemical examination of patients with degenerative diseases of large joints before and after TAJ, determine the changes in the markers of the hemostasis system and inflammatory processes, which are the most informative for the preoperative prediction of the development of hypercoagulable conditions. Methods. In the blood serum of 39 patients with degenerative diseases of the hip and knee joints of III–IV stages according to Kellgren–Lawrence before and after TAJ, the following were investigated: prothrombin time, international normalized ratio (INR); the content of fibrinogen, soluble fibrin-monomeric complexes (SFMC), D-dimer, antithrombin III, glycoproteins (GP), sialic acids, C-reactive protein (SRP), seroglycoides, haptoglobin; activated partial thrombin time (APTT), fibrinolytic activity (FA). The control group consisted of 30 practically healthy donors. The results. Before TAJ, the serum content of GP patients was 28.80 % higher than the control indicators; haptoglobin — by 20.00; CRP — 82.88; SFMC — 33.60; fibrinogen — 60.32; D-dimer — 41.04 %. The INR was reduced by 25.40 %, the content of antithrombin III — by 21.90 %, FA slowed down by 63.00 %. After TAJ, the content of total HP in the blood serum ofpatients exceeded the indicator of the control group by 55.80 %, sialic acids by 35.60 %; seroglycoides — 55.26; haptoglobin — 61.42; CRP — 151.33 %. An additional reduction of 10.58 %, prothrombin time, APTT — by 15.40 %, antithrombin III activity — 19.10 %, increase in fibrinogen content — 34.90 % was observed; D-dimer — 25.10; SFMC — 36.18; prolongation of FA time — by 29.30 %. Conclusions. To prevent the development of thrombophilic conditions after TES, it is necessary to monitor the most informative markers: increase in FA time, content of fibrinogen, D-dimer, SFMC and haptoglobin.

Blood coagulation system in experimental acute lung injury and its treatment with dexamethasone

The effects of short- and long-term administrations of dexamethasone on survival, severity of pulmonary edema, and hemostasis on experimental lipopolysaccharide-induced acute lung injury in rats were analyzed. Acute lung injury in rats was modeled by the intratracheal injection of lipopolysaccharide from the Salmonella enterica cell wall. White male rats were randomly divided into nine groups: the intact group consisted of 10 animals; two control groups of 20 animals each, in which acute lung injury was simulated without further treatment and removed from the experiment on day 3 or 7; six comparison groups of 20 animals each, in which, 3 h after modeling of acute lung injury and then once a day for 3 days (short mode of administration) or 7 days (long mode of administration), dexamethasone solution was administered intraperitoneally in the following doses: 0. 52 (equivalent to 6 mg/day for humans), 1. 71 (20 mg/day for humans), and 8 mg/kg/day (94 mg/day, pulse therapy for humans). On days 3 and 7, the survival rate, coagulogram values (active partial thromboplastin time, prothrombin time, activity of antithrombin, and soluble fibrin monomer complexes), and low-frequency piezotromboelastography data were assessed in the surviving animals. The results revealed that dexamethasone reduces mortality in acute lung injury and has a dose-dependent effect on the hemostasis system: with an increase in the dose administered, blood clotting processes increase and fibrinolysis is inhibited. Low-frequency piezothromboelastography with a conventional coagulogram allows for a comprehensive assessment of the hemostasis system, identifying violations, and timely drug correction.

Activation of intravascular blood coagulation in the early postoperative period in reconstructive abdominoplasty

Purpose of the study: to determine the activity of intravascular blood coagulation during the abdominoplasty and justify pharmacological thromboprophylaxis.Material and Methods. An open prospective study was conducted on a group of 100 patients undergoing abdominoplasty. The risk of venous thromboembolism (VTE) before the surgery was assessed using the Caprini risk assessment model in 2010. Prothrombin (PT) and fibrinogen (FG) levels, soluble fibrin-monomer complexes (SFMC), euglobulin clot lysis time (ECLT), antithrombin III (AT-III) level, and protein C (PC) level were determined before and after the surgery.Results. Using the Caprini risk assessment model, patients were categorized by VTE risk as follows: moderate risk – 64% and high risk – 36%. After the surgery, an increase in PT by 12.3% and 15.5% on days 3 and 5 was observed (p < 0.01); an increase in FG by 0.49; 2.34 and 2.04 g/L on days 1, 3, and 5 was observed (p < 0.01); an increase in SFMC at all postoperative stages by 4.7; 8.2; 10.8 and 10.0 times (p < 0.01); an increase in ECLT by 2.8; 9.7, and 6.3 minutes on days 1, 3, and 5 (p < 0.001); and a decrease in AT-III and PC levels immediately after the operation by 18.8% and 8.9%, on day 1 by 14.2% and 11.2%, and on day 3 by 8.8% and 6.3% (p < 0.01).Conclusion. All patients undergoing abdominoplasty require pharmacological thromboprophylaxis due to moderate and high risk of venous thromboembolic complications. Abdominoplasty in the early postoperative period is accompanied by activation of plasma coagulation, inhibition of fibrinolytic system activity, and reduced activity of natural anticoagulants, which justifies the need for pharmacological thromboprophylaxis for at least 5 days.

Assessment of plasma hemostasis system in the early postoperative period in patients after abdominoplasty

Introduction Venous thromboembolic complications after abdominoplasty are associated with increased intraabdominal pressure and altered venous return without taking into account possible changes in the activity of the blood coagulation system.Purpose of work was to evaluate the state of the plasma hemostasis system in the early postoperative period in patients after abdominoplasty.Materials and methods The study included 100 patients who underwent aesthetic abdominoplasty. Prothrombin (PT), fibrinogen (FG), activated partial thromboplastin time (APTT), soluble fibrin-monomer complexes (SFMC), euglobulin clot lysis (ECL), antithrombin-III (AT-III), and protein C (PrC) levels were evaluated before surgery, immediately after surgery, on the first, third and fifth days after surgery. Statistical data analysis was performed using SPSS 16, Excel 2010 for Windows, using the Kruskal – Wallis criterion.Results Coagulation hemostasis was characterized by a decrease in PT immediately after the surgery and on the first day by 13.9 and 5.3, and an increase in PT on the third and fifth days by 12.3 and 15.5 (p < 0.001), decrease in FG on the first, third and fifth days by 0.49 g/L, 2.34 g/L, and 2.04 g/L, respectively (p < 0.001). SFMC increased at all postoperative stages by 4.7, 8.2, 10.8, and 10.0 times (p < 0.001). Inhibition of XII-dependent fibrinolysis was characterized by an increase in ECL time on the first, third and fifth days by 2.8, 9.7, and 6.3 minutes, respectively (p < 0.001). AT-III and PrC levels decreased immediately after the surgery by 18.8 and 8.9, on the first day by 14.2 and 11.2, and on the third day by 8.8 and 6.3 respectively (p < 0.001).Discussion Activation of blood coagulation processes with imbalance of coagulation, anticoagulation, and fibrinolytic systems create conditions for venous thrombosis formation after abdominoplasty, which substantiates the necessity of VTE pharmacoloprophylaxis for at least five days.Conclusion In the early postoperative period abdominoplasty is accompanied by activation of plasma coagulation, inhibition of fibrinolytic system activity and reduction of natural anticoagulant activity.

Coagulation Biomarkers and Clinical Outcomes in Elderly Patients With Nonvalvular Atrial Fibrillation: ANAFIE Subcohort Study

BackgroundLittle is known about the relationship between coagulation biomarkers and clinical outcomes in patients with atrial fibrillation (AF) treated with anticoagulants, especially direct oral anticoagulants (DOACs) and warfarin. ObjectivesThis subcohort study evaluated the association between coagulation biomarkers and clinical outcomes in elderly Japanese patients with nonvalvular AF using the ANAFIE (All Nippon AF In the Elderly) Registry. MethodsPatients with a definitive diagnosis of nonvalvular AF and aged ≥75 years at enrollment were included. At enrollment, biomarker levels for D-dimer, thrombin–antithrombin complex (TAT), prothrombin fragment 1+2 (F1+2), and soluble fibrin monomer complex (SFMC), along with data on anticoagulant use, were recorded. ResultsOf the 3,194 patients, 95.1% were using oral anticoagulants (OACs) (71.7% DOACs, 23.4% warfarin). D-dimer, TAT, and F1+2 levels, as well as the proportion of patients with a positive SFMC, were lower among those receiving OACs compared with those not receiving OACs. In the DOAC group, higher levels of D-dimer (≥1.0 μg/mL) and TAT (>3 ng/mL) were significantly associated with increased incidences of cardiovascular (CV) events (stroke, myocardial infarction, cardiac intervention, heart failure, and CV death), all-cause death, and CV death. In the warfarin group, higher levels of D-dimer were significantly associated with increased rates of all-cause death, higher levels of TAT with increased major bleeding, and positive SFMC with increased major bleeding and CV events. ConclusionsHigher levels of coagulation biomarkers were associated with a higher risk of worse clinical outcomes, and the relationships between the coagulation biomarkers and outcomes differed between the DOAC and warfarin groups. (Prospective Observational Study in Late-Stage Elderly Patients with Non-Valvular Atrial Fibrillation All Nippon AF In Elderly Registry-ANAFIE Registry; UMIN000024006)

Overestimation of fibrinogen concentration in cryoprecipitate by repeated freeze-thawing with long thawing period as used in the Clauss method.

Cryoprecipitate (CRY) is widely used for treating acquired hypofibrinogenemia. During our study to determine an optimal preparation method, we noticed that the measurement of fibrinogen concentration in CRY had a risk of overestimation. We analyzed this condition and mechanism. CRY was prepared from fresh frozen plasma (FFP) under four conditions: A, 30 h thawing time, 2 cycles; B, 24 h thawing time, 2 cycles; C, 30 h thawing time, 1 cycle; and D, 24 h thawing time, 1 cycle. Then, fibrinogen concentrations in CRY and cryosupernatant (CS) were measured by the Clauss method. Purification (CRY/CRY+CS) and recovery (CRY/FFP) rates in CRY prepared under 2-cycle conditions were higher than those under 1 cycle. However, recovery rates often exceeded 100%, particularly in the case of CRY prepared under A condition, and fibrinogen concentrations calculated by direct measurement were higher than those indirectly calculated from FFP and CS, suggesting an overestimation of fibrinogen values. The level of soluble fibrin monomer complex was considerably higher in CRY prepared under A than under D condition, indicating that CRY adopted a hypercoagulated state. We further found that repeated thawing/freezing increased fibrinogen values as measured by the Clauss method while mechanical vortexing did not. Our findings suggest that direct assessment of fibrinogen contents in CRY prepared by repeated freeze-thawing with a longer thawing period presents a higher risk of overestimation. For the purpose of quality control, we propose an alternative method to indirectly estimate fibrinogen concentrations in CRY from those of CS and FFP.

Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about?

Numerous studies have indicated that alopecia areata is associated with a chronic systemic inflammation, which is considered as a risk factor for venous thromboembolism. The aim of the study was to evaluate the following markers of venous thromboembolism risk: soluble fibrin monomer complex (SFMC), thrombin-antithrombin complex (TATC), and prothrombin fragment 1 + 2 (F1 + 2) in patients with alopecia areata and compare them with healthy controls. In total, 51 patients with alopecia areata [35 women and 16 men; mean age: 38 (19-54) years] and 26 controls [18 women and 8 men; mean age: 37 (29-51) years] were enrolled in the study. The serum concentrations of thromboembolism markers were measured using an enzyme-linked immunosorbent assay (ELISA) kit. An increased level of SFMC was detected in patients with alopecia areata compared with the controls [25.66 (20-34.86) versus 21.46 (15.38-29.48) µg/ml; p < 0.05)]. In addition, a higher level of F1 + 2 was observed in patients with alopecia areata in comparison with the control group [70150 (43720-86070) versus 38620 (31550-58840) pg/ml; p < 0.001]. No significant correlation was detected among SFMC or F1 + 2 and the Severity of Alopecia Tool(SALT)score, disease duration, or the number of the hair loss episodes. Alopecia areata may be associated with an increased risk of venous thromboembolism. Regular screening and preventive management of venous thromboembolism may be beneficial in patients with alopecia areata, especially before and during systemicJanus kinase (JAK) inhibitors or glucocorticoid therapy.

Plasma levels of fibrinolytic and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy: A case-control study in a Northern Ghanaian population.

Impaired coagulation and fibrinolysis have been implicated in thromboembolism in human immunodeficiency virus (HIV)-infected individuals. This study evaluated the plasma levels of plasminogen activator inhibitor-1 (PAI-1) and coagulation biomarkers in HIV-infected individuals on highly active antiretroviral therapy (HAART). This matched case-control study from March to December, 2020 comprised 76 participants: 38 HIV-positive individuals on HAART and 38 apparently healthy HIV-negative individuals as controls. Blood samples were collected for prothrombin time (PT), activated partial thromboplastin time (aPTT), D-dimers, PAI-1, and soluble fibrin monomer complex (SFMC) estimations. The data were analysed using SPSS version 22.0 and statistical significance was set at p < 0.05. Activated partial thromboplastin time was significantly lower in HIV seropositive individuals on HAART compared with HIV seronegative controls (25.90 s vs. 29.0 s, p = 0.030); however, PT, SFMC, D-dimers, and PAI-1 were significantly higher among the HIV-seropositive individuals compared with the controls: PT: (16.29 s ± 2.16 vs. 15.15 s ± 2.60, p = 0.010), SFMC: [8.53 ng/mL (8.03-9.12) vs. 7.84 ng/mL (7.32-8.58), p = 0.005]), D-Dimer: [463.37 ng/mL (402.70-526.33) vs. 421.11 ng/mL (341.11-462.52), p = 0.015], and PAI-1: [12.77 ng/mL (10.63-14.65) vs. 11.27 ng/mL (10.08-12.95), p = 0.039]. PAI-1 showed a moderate positive correlation with D-Dimer (r = 0.659, p < 0.001) and SFMC (r = 0.463, p = 0.003) among HIV-positive individuals on HAART. There was a strong positive correlation between the plasma PAI-1 concentration and the HIV viral load (r = 0.955, p < 0.001). HIV-seropositive individuals on HAART have deranged coagulation and fibrinolytic markers. Higher HIV viral load correlates strongly with elevated plasma levels of PAI-1 antigens. Periodic assessment of markers of coagulation and fibrinolysis be included in the management of HIV/AIDS in Ghana.

Digital diagnostics: A computer application for lymph node metastases in cervical cancer

BACKGROUND: Since 2020, staging accuracy improvements in cervical cancer (CC) revealed that major errors occur due to missed metastases to regional lymph nodes. The presence or absence of metastases seriously affects the staging of cancer and, consequently, its treatment methods, since metastases make cancer inoperable.&#x0D; AIM: To develop an application to help the doctor in predicting metastases to regional lymph nodes in CC, with the ability of installing on any personal computer regardless of the operating system (Windows, Linux, or Mac OS) and saving data about the patients.&#x0D; METHODS: The development was performed on the .NET platform (framework v4.7.2), by means of C# language, based on a proprietary prognostic model using seven blood parameters such as erythrocyte sedimentation rate, erythrocytes, hemoglobin, fibrinogen, D-dimer, and platelet aggregation with adenosine diphosphate and soluble fibrin monomer complexes.&#x0D; RESULTS: A window application was developed that automatically calculates the probability of metastases to regional lymph nodes in СС and provides the ability to save the data from the input form and the predicted value into TXT and/or CSV files. TXT and CSV formats are supported in various operating systems. The .txt file allows each individual patients prognosis results to be saved in a separate file for easy printing and attachment to the patients electronic or paper medical record. The CSV file format enables the aggregation of data of all patients by adding line-by-line data from the input form to the end of the file.&#x0D; CONCLUSIONS: The developed application facilitates the process of using the patented formula to diagnose metastases to regional lymph nodes in СС at the early stages of examination, which allows choosing the optimal tactics and, consequently, improving the prognosis of the disease.

Analysis of the relationship between degenerative changes in the joint under conditions of hip osteoarthritis with hemostasis disorders in patients based on the results of a biochemical study

Venous thromboembolism is one of the serious complications that occurs after total hip arthroplasty (THA). Among the risk factors may be the presence of disorders of hemostasis and fibrinolysis in patients before surgical intervention. The aim of study to identify the influence of hip osteoarthritis III–IV stages on the hemostasis of patients before performing THA. Methods. A prospective study was conducted with the participation of 60 patients with hip ostheoarthritis III–IV stages and 30 healthy volunteers (control group). Blood and urine samples were obtained from all participants (in patients — one day before THA). Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, fibrinolytic activity (FA), soluble fibrin monomer complexes (SFMCs), glycoproteins, sialic acids, chondroitin sulfates (CS), acid and alkaline phosphatases, β lipoproteins were determined in the blood; in urine — oxyproline, uronic acids, Ca and P. The Pearson correlation coefficient (r) was calculated to determine the relationship between markers of hemostasis and connective tissue metabolism. Results. Compared with the control group, the level of alkaline phosphatase in the blood of patients with hip ostheoarthritis level of glycoproteins (r = 0.97; p &lt; 0.05), cholesterol (r = 0.91; p &lt; 0.05); the level of SFMCs was correlated with the level of glycoproteins (r = 0.99; p &lt; 0.05), CS (r = 0.94; p &lt; 0.05). Conclusions. In patients with hip ostheoarthritis III-IV stages the levels of connective tissue markers (glycoproteins, CS) correlate with the levels of hemostasis markers (fibrinogen, SFMCs). This is of clinical significance for the timely prevention of the development of thromboembolic complications in patients to whom THA is recommended.

Functional Dynamics of Hemostasis and Hemorheology in Young Men at Risk of Arterial Hypertension

Of great medical and social importance in modern conditions is the increase in the effectiveness of preventing the development of arterial hypertension at a young age. Purpose of the work: to evaluate the impact of systematic dosed jogging on the parameters of the homeostasis system and the rheological properties of blood in adolescents with a predisposition to the development of arterial hypertension. The study included 60 young men with high normal blood pressure and the risk of developing arterial hypertension with normal body weight. They were divided into 2 groups. The first of them (31 people) began regular jogging for 1 hour a day, 6 times a week for 1 year. The second group (29 young men) kept their previous inactive way of life. The work took into account the level of blood pressure, the amount of fibrinogen in the blood, plasminogen activity, the amount of soluble fibrin-monomer complexes, activated partial thromboplastin time, international normalized ratio, platelet aggregation, blood viscosity. Student's t-test was calculated. As a result of regular jogging in young men with a predisposition to the formation of arterial hypertension, it was possible to normalize the level of blood pressure, homeostasis parameters and hemorheology parameters taken into account. The changes achieved had a very positive effect on microcirculation, providing a general recovery. Long-term low physical activity in young men at risk of developing arterial hypertension contributed to the preservation of elevated blood pressure numbers, aggravation of homeostasis disorders and deterioration of blood rheology.

Coagulopathy is Initiated with Endothelial Dysfunction and Disrupted Fibrinolysis in Patients with COVID-19 Disease.

The online version contains supplementary material available at 10.1007/s12291-023-01118-3.

Characteristics of Products of Fibrinogen Origin in the Presence of Anti- SARS-CoV-2 IgG in the Bloodstream.

The hemostasis system has been extensively investigated in patients in the acute phase of coronavirus disease 2019 (COVID-19). In contrast, the post-COVID syndrome is a poorly known entity, and there is a lack of information on the mechanisms underlying the hemostasis abnormalities in the post-COVID period. To analyze the potential changes in the parameters of the hemostasis system in the post- COVID period in the plasma of donors with different titers of anti-SARS-CoV-2 IgG. The plasma from 160 donors who had recovered from COVID infection was used in the study. Based on the results of the Abbott SARS-CoV-2 IgG serological assay, all donors were divided into several groups: 5 ± 3 (n = 20); 55 ± 5 (n = 20); 65 ± 5 (n = 20); 75 ± 5 (n = 20); 85 ± 5 (n = 20); 95 ± 5 (n = 20); 125 ± 5 (n = 20); 175 ± 5 (n = 20) Index (S/C). A total of 20 healthy individuals without anti-SARS-CoV-2 IgG constituted the control group. Key laboratory parameters, such as fibrinogen concentrations, soluble fibrin monomer complex (SFMCs), and Ddimer, were investigated. In addition, the qualitative composition of the fraction of SFMCs was analyzed. The slight increase in the concentration of fibrinogen, SFMCs, and D-dimers in some donor groups have been found, which could cause the development of hemostasis disorders. In the fraction of SFMCs, the increase in the number of protein fragments with a molecular weight of less than 250 kDa and an increase in the level of proteins with a molecular weight of more than 270 kDa was revealed. The obtained results indicated the relationship between the changes in the parameters of the hemostasis system and the titers of anti-SARS-CoV-2 IgG in donors in the post-COVID period. It can be assumed that donors with higher titers of anti-SARS-CoV-2 IgG (>55 ± 5 Index (S/C)) are more prone to hemostasis abnormalities in the post-COVID period since a pronounced imbalance in the levels of SFMCs and D-dimer characterizes them. The appearance of protein fragments of different molecular weights in the fraction of SFMC points to uncontrolled activation of biochemical processes involving molecules of fibrinogenic origin. Additional studies are required to elucidate the role of anti-SARS-CoV-2 IgG in the post-COVID period.

Rozchynni fibryn-monomerni kompleksy i D-dymery yak pokaznyky tiazhkosty hostroho pankreatytu

Introduction. Local and systemic inflammation, disorders in the hemostatic system are among the key components of acute pancreatitis (AP) pathogenesis already in its early stages, and in future development of thrombohemorrhagic complications. The degree of systemic hemostatic disorders in AP varies from subclinical activation of coagulation, which can only be detected using sensitive markers of activation of coagulation factors, to fulminant disseminated intravascular coagulation syndrome, characterized by multiple systemic microvascular thrombosis and profuse bleeding from different sites. It has been proven that D-dimers and soluble fibrin-monomeric complexes (SFMK) are valuable markers of coagulation and fibrinolysis activation. The aim of the study. To study the dynamics of D-dimers, soluble fibrin-monomeric complexes in the blood of patients with acute pancreatitis, depending on the severity of the disease. Materials and methods. A prospective examination of 206 patients with AP was carried out. According to the criteria of the International Classification, mild pancreatitis was verified in 51 patients, moderate – in 98, severe – in 57. The concentration of SFMK, D-dimers was determined in 66 patients with AP on the first, third, seventh and fourteenth days of conservative treatment. The reference values were estimated in 11 healthy individuals. Results. The enhansed concentration of SFMK and D-dimers were detected in the blood of all patients under examination. Their content directly correlated with the severity of AP course as determined by the Ranson and BISAP score, the severity of the patient’s condition by the APACHE II score and organ dysfunction by the SOFA score, and the degree of damage to the pancreas by the Balthazar criteria. The concentration of SFMK and D-dimers significantly increased with the occurrence of respiratory, cardiovascular, renal, and metabolic dysfunction. A reliable direct correlation was determined between the amount of SFMK and the concentration of creatinine and glucose in the blood of patients with AP. The increase in the level of D-dimers significantly directly correlated with the concentration of creatinine in the blood serum. The sensitivity of SFMK determination (cut-of value 137.50 ng/L) for predicting pulmonary dysfunction was 86.20 %, and the specificity was 83.80 %, with positive and negative predictive values of 80.65 and 88.57 % respectively. Conclusions. The course of acute pancreatitis is accompanied by local or systemic inflammation, changes in the hemostatic system, severity of which correlating with the severity of the disease. Characteristic feature for patients with severe acute pancreatitis is the combination of systemic inflammation with procoagulant changes. The severity of acute pancreatitis, the severity of patient’s condition and organ dysfunction, the severity of pancreatic lesions are associated with an increase of fibrin degradation products. The concentration of soluble fibrin-monomeric complexes can be used to predict pulmonary dysfunction in patients with acute pancreatitis.

Study on the relationship of soluble fibrin monomer complex and the risk of induced cardiovascular and cerebrovascular events in patients with heart failure

Study on the relationship of soluble fibrin monomer complex and the risk of induced cardiovascular and cerebrovascular events in patients with heart failure

USE OF ANTICOAGULANT DRUGS IN THE COMPLEX TREATMENT OF NONUNION OF TIBIA BONES

Relevance. Today there is no generally accepted scope of treatment for nonunion of the tibia. Treatment results are often unsatisfactory. The incomplete process of bone tissue repair is due to the presence of metabolic changes and vascular disorders. This suggests that the use of anti-clotting drugs in the complex treatment may contribute to better treatment results.&#x0D; Objective: to study the effectiveness of the use of antiplatelet drugs bemiparin and tranexamic acid in the complex repair of bone tissue.&#x0D; Materials and methods. 36 patients with tibia nonunion were treated. Complex therapy included surgical treatment (rehabilitation of inflammation and, if present, fistula sequestrectomy), fixation of fragments with ring fixators, antibacterial therapy according to generally accepted principles, conservative therapy of vascular disorders, correction of homeostasis. The comparison group consisted of 42 victims.&#x0D; To correct homeostasis before surgery, 750 mg of tranexamic acid solution was administered intravenously to reduce the risk of bleeding. In 6 hours after surgery, in order to prevent thrombosis, a prophylactic dose of bemiparin (Cibor) 25000 units was administered. The administration was carried out for 7 days. The state of blood homeostasis was assessed on 1, 3 and 7 days after surgery by the following indicators: platelet count, level of soluble fibrin-monomer complexes, prothrombin time, activated partial thromboplastin time, international normalized ratio.&#x0D; The condition of the tibia was assessed by the following indicators: the presence of fluid in the subfascial space, the condition of the fascia, muscles and blood vessels (assessed by ultrasound); asymmetry of the temperature of the feet and legs of healthy and injured limbs (using an infrared non-contact thermometer); the value of intratissue pressure on the tibia (using the Striker apparatus at certain points).&#x0D; The results of tibia treatment after fractures were evaluated using the anatomical and functional scale Modified Functional Evaluation System by Karlstrom-Olerud.&#x0D; Results. There was no significant blood loss during surgery and thromboembolic complications. Clinical data and indicators of intrafascial pressure in the outer and superficial posterior fascial compartments indicated the development of local hypertensive ischemic syndrome. The dynamics of foot thermoasymmetry, ultrasound data are characteristic of subcompensated functional disorders with the theoretical possibility of their recovery. The obtained data indicate a violation of blood flow with a high risk of possible thrombosis, which is an objective basis for the appointment of low molecular weight heparin. The dynamics of most of the examined indicators of blood homeostasis during the prescribed therapy did not differ statistically, but there was a tendency to shift the indicators to the recommended safe zone.&#x0D; Conclusions. Clinical data indicate the high efficacy of Cibor in the complex therapy of septic nonunions.