Vascular-platelet Hemostasis Research Articles

ASSESSMENT OF ERYTHROCYTE PERIPHERAL BLOOD AND ACTIVITY OF HEMOST ASIS IN PATIENTS WITH CER VICAL CANCER

Despite the availability and informative value of methods that facilitate the diagnosis, cervical cancer (CC) does not lose its leading position as one of the most common cancers of the reproductive system in women worldwide. High prevalence of anemia and thrombotic complications in this group determines not only the quality of life of patients, but the outcome of the underlying disease. The purpose of the study was to determine the patterns of change in erythrocyte of peripheral blood and the state of vascular-platelet and coagulation hemostasis in patients with cervical cancer depending on the stage of disease and histological variant of the tumor. Materials and methods. We investigated the performance of erythron, thrombocytic and coagulation hemostasis in 74 patients with cervical cancer (mean age 46,49 ± 11,78 years). Blood analysis was performed in the initial evaluation of patients in the prehospital phase. Results. It is proved that the spread of the tumor outside the cervix exerts a systemic influence on hematopoiesis, hemostasis, significantly increasing the risk of venous thromboembolism and hematogenous dissemination of the disease (metastasis). In the case of adenocarcinoma and dimorphic (glandular-squamous) cervical cancer we proved the significant increase in soluble fibrin-monomer complexes, fibrinogen, and with glandular-squamous-cell cervical cancer and hypercoagulability (decrease thrombin time), which requires mandatory and differentiated prevention of venous thromboembolism even in the early stages of these morphological variants of the disease. Conclusions. Cervical cancer has a systemic effect on the blood and hemostasis. A statistically significant decrease in the concentration of hemoglobin and increased erythrocyte sedimentation rate is determined in the second stage of the disease. The increase in the prevalence of cervical cancer and the presence of glandular component in the morphological structure of the tumor was significantly associated with increased thrombosis.

Features of the Hemostasis and Platelets Enzyme Activity in Patients with Different Sensitivity to Acetylsalicylic Acid by the Acute Coronary Syndrome

Aim. To study the features of the state of hemostasis and platelet enzymes activity in acetylsalicylic acid (ASA) sensitive and resistant patients with acute coronary syndrome (ACS). Material and methods. The study included 53 patients (25 men and 28 women) with ACS during the first 24 hours and after 10 days. The control group included 50 healthy volunteers. Before treatment the patients were tested on the sensitivity and resistance to ASA. The indicators of vascularplatelet and plasma hemostasis were evaluated as well as the NAD(P)- dependent dehydrogenases activity in platelets was assessed by the bioluminescent method in the first day of ACS before antiplatelet therapy and on day 10. Results. Increase in spontaneous [1.72 U (1.28-2.72 U) and 1.60 U (1.49-2.78 U), respectively] and ADP-induced [24.4% (21.1-29.8%) and 19.2% (16.1-22.9%), respectively] platelet aggregation, von Willebrand factor activity [159.0% (108.0-190.0%) and 155.0% (149.0-185.1%), respectively] was found in ASA-resistant patients with ACS in 1 and 10 day. Besides the ASA-resistant patients with ACS had very low pentose phosphate cycle and lactate dehydrogenase aerobic activity. They also demonstrated, compared with ASA-sensitive patients, higher intensity of aerobic respiration and the level of NADP-dependent substrate exchange between the tricarboxylic acid cycle and reactions of amino acid metabolism. Conclusion. Despite the dual antiplatelet therapy with ASA and clopidogrel, risk of thrombotic events is saved in ASA resistant patients with ACS. The metabolic changes in platelet influence their aggregation activity and cause an inadequate response to the antiplatelet therapy in ACS patients.

Role of Secondary Brain Damage Factors in Activation of VascularPlatelet Hemostasis in Traumatic Brain Injury

Role of Secondary Brain Damage Factors in Activation of VascularPlatelet Hemostasis in Traumatic Brain Injury

Состояние систем гемостаза и иммунитета у больных острым коронарным синдромом в сочетании с тревожно-депрессивными расстройствами

Anxiety-depressive disorders (ADD) have a negative impact on the course and prognosis of patients with ischemic heart disease, but the mechanisms of their correlation are not studied enough. The purpose of this study was to elucidate special characteristics of hemostasis and immune system in patients with acute coronary syndrome (ACS) combined with ADD. We included into the study 60 patients during first 24 hours of ACS. ADD was identified in 27 patients (45%). Parameters of plasma and vascular-platelet hemostasis and phenotype of lymphocytes were determined in samples of blood taken during first 24 hours and on day 10 of hospitalization. We found that patients with ACS combined with ADD had procoagulant state of hemostasis, increased platelet aggregation, decreased content of lymphocytes and augmented immunoregulatory induction of inflammatory processes.

Evaluation of relationship between endothelial function and vascular-platelet hemostasis in patients with a good compensation of type 2 diabetes mellitus and hypertension

The aim of research. The aim of this study is to determine the relationships between endothelial dysfunction, the degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis in patients with good compensation of type 2 diabetes mellitus and arterial hypertension. Material s and m ethods . In 69 patients with good glycemic compensation using clinical, laboratory, morphological methods and correlational analysis association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis have been identified. Results. Results of correlation analysis showed the presence of credible negative relation between the content of inactivated platelets and concentrations of endothelin-1 (r=-0.53; p<0.05), von Willebrand factor (r=-0.68; p<0.05) and thrombomodulin (r=-0.55; p<0.05). The largest number and strength of correlations between morphological indicators of intravascular platelet activation and studied clinical and laboratory parameters were observed with admiration to the activated and aggregated forms of cells. In particular, elevated levels of activated platelets in patients of this contingent had reliable high degree of direct correlation with the content of glycated hemoglobin (r=+0.79), systolic blood pressure (r=+0.63), the concentration of endothelial dysfunction markers, including the level of albuminuria (r=+0.73), as well as with the values of total cholesterol (r=+0.64) and low density lipoprotein cholesterol (r=+0.79). Content of aggregated platelets statistically significantly positively correlated with the level of glycated hemoglobin (r=+0.73), all markers of endothelial dysfunction, urea concentration (r=+0.51) and creatinine (r=+0.58). In contrast, the relative content of degranulated platelet establish a reliable correlation only with the levels of endothelin-1 (r=+0.75) and thrombomodulin (r=+0.62). On the level of endothelin-1 and thrombomodulin concentration positive linear correlation was found, but alpha-granules located in shut inverse correlation not only with endothelin-1 (r=-0.57; p<0.05), as well as with the concentration of glycated hemoglobin (r=-0.76; p<0.05) and with dyslipidemic changes. Increased platelet aggregation activity in patients with good glycemic compensation, which was manifested in a twofold increase in the content of circulating small units was significantly correlated with the level of glycated hemoglobin (r=+0.66) and the values of systolic blood pressure (r=+0.58), as well as concentrations of markers of endothelial dysfunction and renal function, but did not have any significant relationships with blood lipids in patients of this contingent. Conclusion. It has been established that in the good glycemic control morphological criteria of platelet hemostasis damage clearly correlated with markers of endothelial dysfunction, but did not show significant relationships with indicators of renal function and blood lipid profile.

Oxidative stress in platelets at an oncopathology

To determine the biochemical disorders in the blood coagulation mechanism associated with oxidative stress parameters of the antioxidant status were examined in platelets of 57 colorectal cancer patients, (including 21 patients before and after surgery), and 40 healthy individuals. We determined the total content of nitric oxide (NOx), levels of superoxide dismutase (Cu/ZnSOD), glutathione and malondialdehyde (MDA). Before treatment, we observed the changes in the antioxidant defense system of platelets, which did not depend on the prevalence of malignancy: elevated levels of SOD by 16% (p<0.05), reduced glutathione and MDA in 5.2 and 1.7 times, respectively. NOx levels did not differ from the norm. Significant shifts were found in the postoperative period: they consisted of the increase in the generation of NOx both on the third, and on the 10-th day after surgery. These changes reflect apparently platelet response to the inflammatory process associated with the surgical trauma and confirm the role of NOx as a mediator of inflammation. The content of SOD after surgery was significantly reduced, but return to a baseline on the 10-th day. Despite the significant increase in the number of platelets, no correlations of the studied parameters and their aggregation ability were found.The findings suggest that metabolic disorders in vascular-platelet hemostasis are associated with oxidative stress, which provides a basis for further study of the relationship of cancer to thrombosis.

An effect of valdoxan on the hemostasis in patients with acute coronary syndrome in the combination with anxiety and depressive disorders

To explore the dynamics of hemostasis in patients with acute coronary syndrome (ACS) in the combination with anxiety and depressive disorders (ADD) during therapy with valdoxan (agomelatine). We examined 196 male and female patients (mean age 64.2 ± 0.8 years) in the first 24 hours of ACS. The patients were divided into three groups: patients with ACS without ADD (n=88), patients with ACS and ADD without valdoxan therapy (n=58) and patients with ACS and ADD treated with valdoxan (n=50). Coagulation and vascular-platelet hemostasis were studied in the first 24 hours of hospitalization and in the 10th day of hospitalization. Patients with ACS revealed high levels of fibrinogen, soluble fibrin-monomer complexes, D-dimer at all stages of the study. In patients with ADD, these parameters were significantly higher compared to patients without ADD. The levels of D-dimer in the 10th day were similar in patients with ADD treated with valdoxan and in patients with ACS without ADD. In both groups of patients with ADD, the levels of spontaneous aggregation in the first and 10th days of hospitalization were not significantly higher than in the control group and in patients with ACS without ADD. All patients with ACS had high values of platelet aggregation stimulated by adenosine diphosphate in dose 0.1 uM. In patients with ACS and ADD treated with valdoxan, a significant reduction of these parameters was noted in the 10th day of treatment compared to the first day of hospitalization. The high procoagulant activity of the hemostatic system was observed during all stages of the study in the patients with ACS and ADD who received a combined antithrombotic therapy without valdoxan.

Correlations between clinical, laboratory and morphological parameters of endothelial dysfunction and vascular-platelet hemostasis in patients with type 2 diabetes mellitus and hypertension with poor glycemic compensation

Aim. Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance.Methods and results. In 78 patients with poor glycemic compensation associations between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis were identified using clinical, laboratory, morphological methods and correlational analysis.Conclusion. It has been established that in the poor glycemic control against the background of significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis extremely dense correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes are formed.

Relationship of hyperglycemia with endothelial function, renal function, lipidemic profile, and morphological changes of blood cells in patients with insufficient compensation of type 2 diabetes mellitus with hypertension

Many questions about the relationship between endothelial dysfunction and morphological substrate of hemostasis damage that occur during the progress of type 2 diabetes mellitus and arterial hypertension require clarification and further advance. In 87 patients with insufficient glycemic compensation using clinical, laboratory, morphological methods and correlational analysis were identified association between endothelial dysfunction, degree of renal function damage, lipidemic profile and morphological changes of vascular-platelet hemostasis. It has been established that in the insufficient glycemic control by a significant strengthening relationships between indicators of endothelial dysfunction and damaged platelet hemostasis (up to r=+0.95) formed significant correlations of ultrastructural characteristics of platelets with clinical and laboratory signs of nephropathic and dyslipidemic changes.

Hemostasis in pregnant women with gestational diabetes mellitus

Been analyzed and studied the characteristics of hemostasis in pregnant women with gestational diabetes mellitus. Found that for women with disorders of carbohydrate metabolism characte-rized by increased activity of procoagulant, vascular-platelet hemostasis, and decreased activity of fibrinolityc system. It is shown that the violations of the haemostatic system is directly dependent on the degree of compensation of carbohydrate metabolism and require adequate correction of glycemia. Thus, GDM is an important predictor of hemostatic disorders and possible venous thromboembolism in pregnancy.

Impact of Acute Normovolemic Hemodilution with Autoplasma Transfusion on Hemostatic Parameters during Abdominal Delivery

Objective: to evaluate the impact of acute normovolemic hemodilution (ANH) with autoplasma transfusion on hemostatic parameters during cesarean section. Subjects and methods. The study covered 119 patients in whom ANH was used during cesarean section. Group 1 included 62 women undergoing ANH with autoplasma transfusion; Group 2 (control) comprised 57 pregnant women receiving ANH only. Examination of the hemostatic system involved studies of the plasma link, thromboelastogram readings, vascular platelet hemostasis and evaluation of intravascular thrombogenesis. Results. Transfusion of stored autoplasma as a hemostatic component during ANH favored the development of moderate hypercoagulation due to a significant increase in fibrinogen concentrations by 8%, r+k shortening by 11%, and a rise in the thrombodynamic potential index by 12%. A statistically significant difference has been found in the results between the groups at a stage of surgical hemostasis, which proves the best hemostat-ic effect of ANH used with autoplasma transfusion. Conclusion. The study has demonstrated that the combined use of ANH and autoplasma transfusion contributes to the stabilization of the blood coagulation potential during cesarean section and extends the feasibilities of ANH when the volume of intraoperative blood loss is as high as 25% of the circulating blood volume. Key words: cesarean section, acute normovolemic hemodilution, autoplasma transfusion, coagulation potential.

Vascular-platelet and plasma hemostasis regulators from bloodsucking animals.

Saliva of bloodsuckers (leeches, insects, ticks, vampire bats) contains various regulators of some hemostatic stages. This review summarizes information on their structural characteristics and mechanisms of action. Most bloodsuckers are shown to inhibit vascular-platelet hemostasis by blocking collagen-induced platelet adhesion/aggregation. Plasma hemostasis is inhibited by blocking activation of factor X or factor Xa directly.

Effect of desglycinearginine-vasopressin on excitability of defensive command neurons inHelix lucorum

It was established in dog experiments that aggregation activity of platelets and the rate of aggregation were higher in arterial than in venous blood, with the platelet content being identical. Antiaggregation activity of vascular walls of the arterial system. The data obtained indicate the presence of the arteriovenous difference of the function of the vascular-platelet hemostasis, which is of a role in the processes of regulating the state of blood aggregation in the body.

Possibilities of classification of clinical stages of coronary heart disease by systems of informative indicators of hemostasis

The results of classification of 868 patients (809 with various manifestations of coronary artery disease, 17 with drug allergy and 40 with discoid lupus erythematosus) by systems based on informative parameters of plasma and vascular-platelet hemostasis are presented. The accuracy of class division was achieved in the range of 43.8-100.0%, depending mainly on the clarity of the clinical picture of the disease (concomitant diseases and developed complications). The fundamental possibility of using data on the state of hemostasis in general and particular classifying and prognostic systems to determine the severity and stage of the disease is shown.

Possibilities of recognizing the clinical stages of ischemic heart disease according to the data of plasma and vascular-platelet hemostasis

56 indicators of the blood coagulation and fibrinolysis system were studied in 866 men, healthy and suffering from coronary artery disease. Based on the mathematical analysis, tables of the significance of individual indicators for recognizing the clinical stages of coronary artery disease were compiled.

A model of disseminated intravascular blood clotting

Vascular-platelet and plasma hemostasis was studied in dogs after blood loss (40–45 ml/kg body weight) followed by hypervolemic (60–65 ml/kg body weight) transfusion of homologous (from three donors) plasma enriched with platelets and leukocytes. After a brief phase of hypercoagulation, hypocoagulation was discovered in all the experimental dogs, accompanied by a reduction in the platelet count and in the intensity of platelet aggregation, lengthening of the bleeding time, a decrease in the resistance of the capillary wall, a decrease in the plasma fibrinogen concentration and activity of factor XIII, and an increase in the fibrinolytic activity of the blood. The results are evidence of the development of an acute syndrome of disseminated intravascular blood clotting.