Effects of Intermittent Pneumatic Calf Compression On Postoperative Thrombin and Plasmin Activity

1986 ◽  
Vol 56 (02) ◽  
pp. 198-201 ◽  
Author(s):  
Jeffrey Weitz ◽  
Jost Michelsen ◽  
Kenneth Gold ◽  
John Owen ◽  
Duncan Carpenter
Keyword(s):  
Enzyme Activity ◽  
Fibrinopeptide A ◽  
Plasmin Activity ◽  
Neurosurgical Patients ◽  
The Mean ◽  
Calf Compression

SummaryA previous study of neurosurgical patients demonstrated an imbalance between thrombin and plasmin action following surgery. The present study was designed to determine the effect of intermittent pneumatic calf compression on postoperative enzyme activity. Fibrinopeptide A (FPA) and Bβ 1-42 levels, reflecting thrombin and plasmin action respectively, were measured daily in patients undergoing elective craniotomy. Two of 9 patients not receiving calf compression developed positive fibrinogen leg scans, while none of 5 patients receiving prophylaxis had positive scans. Calf compression was associated with a markedly altered pattern of changes in the fibrinopeptide values following surgery. Without compression, there was perturbation of the balance between thrombin and plasmin action on the day after surgery as reflected by an increase in the FPA/Bβ 1-42 ratio. In contrast, in those receiving prophylaxis there was no change in this ratio on the first postoperative day. Calf compression both blunted the mean postoperative increase in the FPA level (1.8 nM vs 4.7 nM; p <.05) and augmented the mean Bβ 1-42 value (3.0 nM vs 0.2 nM; p <.05) so that the mean increase in the FPA/ Bβ 1-42 ratio was only 0.1 with calf compression as compared to 2.2 without it (p <.05). Systemic modulation of both the coagulation and fibrinolytic pathways thus occurred in association with calf compression.

Estimation of Na\K - ATPase Enzyme Activity and Endogenous Digitalis in Patients with Diabetic Neuropathy

2021 ◽  
Vol 19 (5) ◽  
pp. 95-103
Author(s):  
Eman Hameed Al-Rikabi ◽  
Mazin J. Mousa ◽  
Oda M. Yasser
Keyword(s):  
Enzyme Activity ◽  
Diabetic Neuropathy ◽  
Inhibitory Activity ◽  
Strong Association ◽  
Clinical Manifestations ◽  
Gradual Loss ◽  
Study Results ◽  
Healthy Control ◽  
The Mean ◽  
Age Range

Background: Among the most common complications of diabetes is diabetic neuropathy (DN). Diabetic neuropathy is a heterogeneous group of disorders, which involves a different part of somatic and autonomic nervous systems, with a gradual loss of neural conductivity. Some studies have shown that they reduce the activity of the Na/K ATPase, however, elevated levels of endogenous sodium pump inhibitor in diabetic individuals, including those with neuropathy. Changes in this transfer enzyme are believed to be due to several diabetes complications. Objective: The study had designed to evaluate the Na/K ATPase enzymatic activity in the erythrocyte-membrane among three groups. The first group had represented the patients with type 2 diabetes mellitus (DM2) and neuropathy. The second group is diabetics without neuropathy. The third group was a healthy subject. As well, the study had estimated the inhibitory activity of endogenous digitalis among patient groups. Furthermore, the aim of this research was to see whether there was a connection between red blood cell membrane Na-K ATPase activity and the medical facts of the analysis subjects. Design and Methods: One-hundred fifty subjects had enrolled in this case-control study; 80 patients complained of diabetic neuropathy of both sexes, the mean age 59.3 years with an age range of 40-81, 40 DM2 without neuropathy (53.9 years), (35 – 70), and 30 healthy controls (30 years, 25 to 45). Patients in the first group were selected carefully according to their clinical manifestations and the nerve conduction study results. The evaluations of both inhibitory activities of endogenous digitalis and Na/K ATPase had completed using a spectrophotometer. Enzyme activity had expressed in micrograms of phosphate concentration per grams of red cell ghost total protein concentration. Results: The mean enzyme activity of Na/K ATPase was significantly lower (p<0.001) in patients with diabetic neuropathy (381±17.9) compared with the diabetic group without neuropathy (498±22.9) and the normal controls (837±61.43). There was a significant inhibitory activity of endogenous digitals (17.87±2.15) in patients with DNP, compared with the diabetics without neuropathy (8.78±0.89) and healthy control (5.3±1.33). There was a significant association of enzyme activity with the following parameters: duration of diabetes, age, level of glycated hemoglobin and endogenous digitalis with the respective p-values (0.000, 0.000, 0.000 and 0.021). Gender showed no significant relationship with enzyme activity (p 0.43). Conclusions: In DM2 with neuropathy, hyperglycemia can much reduce the activity of erythrocyte Na/K ATPase. In addition, it may enhance the inhibitory activity of endogenous digitals. The timedependent increase in diabetic complications can be due to a strong association between diabetes duration and erythrocyte Na/K-ATPase activities.

scholarly journals Patient out-of-pocket spending in cranial neurosurgery: single-institution analysis of 6569 consecutive cases and literature review

2018 ◽  
Vol 44 (5) ◽  
pp. E6 ◽  
Author(s):  
Seungwon Yoon ◽  
Michael A. Mooney ◽  
Michael A. Bohl ◽  
John P. Sheehy ◽  
Peter Nakaji ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cost Sharing ◽  
Financial Burden ◽  
Vascular Lesions ◽  
Annual Growth Rate ◽  
Model Case ◽  
Patient Cost ◽  
Neurosurgical Patients ◽  
The Mean ◽  
Insured Patients

OBJECTIVEWith drastic changes to the health insurance market, patient cost sharing has significantly increased in recent years. However, the patient financial burden, or out-of-pocket (OOP) costs, for surgical procedures is poorly understood. The goal of this study was to analyze patient OOP spending in cranial neurosurgery and identify drivers of OOP spending growth.METHODSFor 6569 consecutive patients who underwent cranial neurosurgery from 2013 to 2016 at the authors’ institution, the authors created univariate and multivariate mixed-effects models to investigate the effect of patient demographic and clinical factors on patient OOP spending. The authors examined OOP payments stratified into 10 subsets of case categories and created a generalized linear model to study the growth of OOP spending over time.RESULTSIn the multivariate model, case categories (craniotomy for pain, tumor, and vascular lesions), commercial insurance, and out-of-network plans were significant predictors of higher OOP payments for patients (all p < 0.05). Patient spending varied substantially across procedure types, with patients undergoing craniotomy for pain ($1151 ± $209) having the highest mean OOP payments. On average, commercially insured patients spent nearly twice as much in OOP payments as the overall population. From 2013 to 2016, the mean patient OOP spending increased 17%, from $598 to $698 per patient encounter. Commercially insured patients experienced more significant growth in OOP spending, with a cumulative rate of growth of 42% ($991 in 2013 to $1403 in 2016).CONCLUSIONSEven after controlling for inflation, case-mix differences, and partial fiscal periods, OOP spending for cranial neurosurgery patients significantly increased from 2013 to 2016. The mean OOP spending for commercially insured neurosurgical patients exceeded $1400 in 2016, with an average annual growth rate of 13%. As patient cost sharing in health insurance plans becomes more prevalent, patients and providers must consider the potential financial burden for patients receiving specialized neurosurgical care.

FIBRINOPEPTIDE B6 15-42 IN LIVER CIRRHOSIS: A SENSITIVE INDICATOR OF MILD FIBRINOLYSIS ACTIVATION

1987 ◽  
Author(s):  
F Marongiu ◽  
M R Acca ◽  
G Mulas ◽  
M Conti ◽  
G Sorano ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Plasminogen Activators ◽  
Fibrinopeptide A ◽  
A Posteriori ◽  
Plasmin Activity ◽  
Coagulation Activation ◽  
Cirrhotic Patients ◽  
Student’S T ◽  
Student’S T Test

In order to detect even minimal fibrinolysis activation in liver cirrhosis and to investigate whether an increased plasmin activity is related to a mild blood coagulation activation, we measured fibrinopeptide A (FPA) (Mailinckrodt) and fibrinopeptide BB 15-42 (BB 15-42) (IMCO and SORIN Biomedica) in 26 patients (16 men and 10 women, mean age 55.8 ± 13.1 years) with histologically proven liver cirrhosis..Mann-Whitney test, Student’s t test and correlation coefficient r were employed for statistical analysis when appropriate.FPA and BB 15-42 were not normal distributed and thus their levels were exprsessed as median and range.FPA values were significantly different in cirrhotic patients (3.9, 0.9-24.2 ng/ml) from those of the controls (2.5, 0.5-3.9 ng/ml) (p < 0.01).BB 15-42 levels were significantly higher in cirrhotic patients (19.4, 7.1-103.1 ng/ml) than in controls (10.4, 5.1-15.4 ng/ml) (p < 0.01). A posteriori the patients were divided in two subgroups according to whether their FPA levels were high (subgroup 1, n=10, FPA>4.0 ng/ml) or normal (subgroup 2, n=16, FPA < 4.0 ng/ml).In patients with high FPA levels we found higher levels of BB 15-42 (22.2, 9.9-103.1 ng/ml) than in patients with normal FPA (13.6, 7.1-30.7 ng/ml ).Thvis difference was significant (p < 0.02) .There was no relationship between FPA and BB 15-42.Our data indicate that in liver cirrhosis a mild fibrinolysis activation may occur.The role of a chronic intravascular coagulation appears to be significant in this regard.However the impaired clearance of plasminogen activators, the decreased synthesis of fibrinolysis inhibitors and the decreased levels of hystidine rich glycoprotein may be also involved in determining fibrinolysis activation as suggested by the lack of correlation between FPA and BB 15-42.

scholarly journals The effects of starvation and experimental diabetes on phosphoenol-pyruvate carboxykinase in the guinea pig

1977 ◽  
Vol 164 (2) ◽  
pp. 357-361 ◽  
Author(s):  
K R F Elliott ◽  
C I Pogson
Keyword(s):  
Enzyme Activity ◽  
Guinea Pig ◽  
Phosphoenolpyruvate Carboxykinase ◽  
Blood Glucose Concentration ◽  
Mitochondrial Fraction ◽  
Kidney Cortex ◽  
Total Enzyme Activity ◽  
The Mean ◽  
Mean Blood Glucose ◽  
Total Enzyme

1. Approx. 85% of liver phosphoenolpyruvate carboxykinase is associated with the mitochondrial fraction in the fed guinea pig. Enzyme activity is unchanged in diabetes, but doubles during starvation. In contrast with earlier reports, both cytoplasmic and mitochondrial activities were found to be increased. 2. In kidney cortex, total enzyme activity is increased in both starved and diabetic animals. These changes are associated with increases in the cytoplasmic activity alone. 3. In diabetic animals the mean blood-glucose concentration was 23.1 mM. Other blood metabolites were lower than those in the rat, and the animals did not show significant ketosis. 4. Changes in the rates of gluconeogenesis from lactate and propionate paralleled those in phosphoenolpyruvate carboxykinase activity.

Intraventricular and lumbar intrathecal administration of antibiotics in postneurosurgical patients with meningitis and/or ventriculitis in a serious clinical state

2013 ◽  
Vol 119 (6) ◽  
pp. 1596-1602 ◽  
Author(s):  
František Remeš ◽  
Robert Tomáš ◽  
Vlastimil Jindrák ◽  
Václav Vaniš ◽  
Michal Šetlík
Keyword(s):  
Clinical Signs ◽  
Multidrug Resistant ◽  
External Ventricular Drainage ◽  
Intrathecal Administration ◽  
Clinical State ◽  
Antibiotic Administration ◽  
Lumbar Drainage ◽  
Time Period ◽  
Neurosurgical Patients ◽  
The Mean

Object To date, reports on the clinical efficacy of intraventricularly and intrathecally administered antibiotics for the treatment of neurosurgical ventriculitis and meningitis in adults are limited. The authors aimed to evaluate the efficacy and safety of the intraventricular (IVT) and lumbar intrathecal (IT) administration of antibiotics in critically ill neurosurgical patients. Methods Thirty-four postneurosurgical patients with meningitis and ventriculitis were studied. Intraventricular/lumbar intrathecal antibiotics were administered due to positive CSF cultures persisting despite the use of intravenous antibiotics. The time period until CSF sterilization, changes in clinical state, and efficacy of different routes of antibiotic administration were evaluated. Results The mean time necessary to obtain CSF sterilization was 2.9 ± 2.7 days (range 1–12 days). The CSF cultures became negative within 24 hours after the administration of IVT/IT antibiotics in 17 patients (50%) and up to 48 hours in a further 6 patients (18%). The clinical outcome of patients assessed by the modified Rankin Scale improved in 17 patients (50%), stayed unchanged in 10 patients (29%), and was impaired in 1 patient (3%). Six patients (18%) died; however, 2 of them died due to reasons not directly related to meningitis or ventriculitis, so the overall mortality rate for meningitis and/or ventriculitis was 11.8% in this group of patients. All patients with ventriculitis (n = 4) were treated by antibiotics administered via the IVT route. The average time to CSF sterilization was 6.5 days in the patients with ventriculitis. Thirty patients had clinical signs of meningitis without ventriculitis. Despite the higher ratio of unfavorable Gram-negative meningitis in the subgroup of patients treated via lumbar drainage, the mean duration of CSF sterilization was 2.2 days compared with 2.6 days in the subgroup treated via external ventricular drainage, a difference that was not statistically significant (p = 0.3). Adverse effects of IVT/IT antibiotics appeared in 3 of 34 patients and were of low clinical significance. Conclusions Intraventricular/lumbar intrathecal antibiotics can lead to very quick CSF sterilization in postneurosurgical patients with meningitis and ventriculitis. The relapse rate of meningitis and/or ventriculitis is also very low among patients treated by IVT/IT antibiotics. Intraventricular/lumbar intrathecal administration of antibiotics appears to be an effective and safe treatment for infections of the CNS caused by multidrug-resistant organisms. In patients with signs of ventriculitis, the authors prefer the IVT route of antibiotics. This study did not prove a lower efficacy of administration of antibiotics via lumbar drainage compared with the ventricular route in patients with meningitis.

scholarly journals Bovine Plasma β-Mannosidase Activity and Its Potential use for β-Mannosidosis Carrier Detection

1992 ◽  
Vol 4 (4) ◽  
pp. 434-440 ◽  
Author(s):  
Kevin T. Cavanagh ◽  
Margaret Z. Jones ◽  
Bruce Abbitt ◽  
Ronald Skinner
Keyword(s):  
Enzyme Activity ◽  
Gene Dosage ◽  
Low Risk ◽  
Carrier Detection ◽  
Biological Factors ◽  
Gene Dosage Effect ◽  
Bovine Plasma ◽  
The Mean ◽  
Potential Use ◽  
Selection Of

Plasma β-mannosidase activities were determined for Salers cattle from 8 herds as an evaluation of this method for detection of β-mannosidosis heterozygotes. Several biological factors, such as age, gender, herd, and risk of being a β-mannosidosis carrier, were considered in this study. The mean enzyme activity for obligate heterozygotes (n = 8) was 55 U/ml (range = 43–65 U/ml), which was 59% of the mean enzyme activity for cattle that were low risk for being a carrier. These data indicate that bovine β-mannosidosis is characterized by a gene dosage effect. The analytical and biological variation of plasma β-mannosidase activity that was observed necessitates limiting the test to adult fullblood/purebred Salers cattle within a herd. Plasma β-mannosidase analysis provides important information for intraherd selection of Salers cattle that are heterozygous for β-mannosidosis.

Serum enzymes in head and neck cancer. IV: 5-nucleotidase

1989 ◽  
Vol 103 (2) ◽  
pp. 200-202 ◽  
Author(s):  
H. Lal ◽  
L. Kumar ◽  
G. S. Kohli ◽  
A. Sharma ◽  
H. Goel
Keyword(s):  
Enzyme Activity ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Mean Value ◽  
Serum Enzymes ◽  
Nucleotidase Activity ◽  
Cervical Metastasis ◽  
The Mean

AbstractSerum 5-nucleotidase levels have been estimated in a group of 50 patients with head and neck cancer. The mean value was significantly higher in patients compared to the controls. In patients with non-malignant growths, the activity was comparable with the controls. The increase was higher in patients with proliferative lesions than those with ulcerative growths. Enzyme activity was found to be increased with the advancement in the stage of cancer. The rise was comparatively higher in patients with cervical metastasis. After radiotherapy, a gradual and significant reduction of serum 5-nucleotidase activity was observed.

Plasma Fibrinopeptide A and Beta-Thromboglobulin in Major Bacterial Infections

1982 ◽  
Vol 48 (03) ◽  
pp. 247-249 ◽  
Author(s):  
H van Hulsteijn ◽  
W Fibbe ◽  
R Bertina ◽  
E Briët
Keyword(s):  
Venous Thromboembolism ◽  
Bacterial Infection ◽  
Venous Thrombosis ◽  
Bacterial Infections ◽  
Fibrinopeptide A ◽  
Healthy Individuals ◽  
The Mean ◽  
Acute Venous Thromboembolism

SummaryThe purpose of this study was to assess the usefulness of plasma fibrinopeptide A and beta-thromboglobulin concentrations for the diagnosis of acute venous thromboembolism in patients with a major bacterial infection. In 80 controls the mean plasma fibrinopeptide A concentration was 0.72 ± 0.47 (ng/ml ± SD) and the mean plasma beta-thromboglobulin concentration 28.2 ± 10.1 (ng/ml ± SD).On admission the mean fibrinopeptide A concentration was significantly raised (5.42 ng/ml) in these patients and 17 of them had a raised fibrinopeptide A concentration. However, the mean beta-thromboglobulin concentration was not significantly different from that of the healthy individuals (35.4 ng/ml) and only three patients had an increased beta-thromboglobulin concentration.Our data show that patients with major bacterial infections tend to have increased fibrinopeptide A and normal beta-thromboglobulin concentrations. Consequently, the measuring of plasma fibrinopeptide A concentration is useless for the diagnosis of acute venous thromboembolism in these patients. However, the determination of plasma beta-thromboglobulin concentration can still be used for this purpose, since a normal beta-thrombo-globulin concentration excludes the presence of acute venous thrombosis.

Plasma Beta-Thromboglobulin, Fibrinopeptide A and Bβ15–42 Antigen in Relation to Postoperative DVT, Malignancy and Stanozolol Treatment

1985 ◽  
Vol 53 (02) ◽  
pp. 235-238 ◽  
Author(s):  
Jessie T Douglas ◽  
S L Blamey ◽  
G D O Lowe ◽  
D C Carter ◽  
C D Forbes
Keyword(s):  
Thrombin Generation ◽  
Double Blind Study ◽  
Fibrinopeptide A ◽  
Intestinal Surgery ◽  
Plasmin Activity ◽  
Double Blind ◽  
Treatment Groups ◽  
Risk Patients ◽  
Platelet Release

SummaryPlasma levels of betathromboglobulin (BTG), fibrinopeptide A (FPA) and Bβ15–42 fragment, indices of platelet release, thrombin generation and plasmin activity respectively, were measured in 32 high risk patients during a double blind study of a single dose of the anabolic steroid stanozolol (50 mg IM) in the prevention of DVT after major gastro-intestinal surgery. The prevalence of malignancy and the incidence of DVT (125I fibrinogen scan) were similar in the two treatment groups. On the first postoperative day, BTG, FPA and Bβ15–42 levels were increased in most patients. Plasma BTG levels were significantly increased on the first post-operative day in patients who developed a DVT (n = 14) compared to those patients who did not (n = 18). A significant increase in FPA levels was found in the DVT group, 7 days after surgery. On the morning before surgery, plasma Bβ15–42 levels were significantly increased in patients who developed a DVT. In patients undergoing surgery for early malignancy (n = 17), we observed a pre-operative increase in FPA levels when compared to patients without malignancy. At post-operative day 7, Bβ15–42 levels were significantly increased in patients who received stanozolol (n = 15), when compared to the placebo group, suggesting that intramuscular stanozolol increases fibrinolysis in vivo.

Adaptation of an Alkaline Phosphatase Method for Automatic Colorimetric Analysis

1959 ◽  
Vol 5 (2) ◽  
pp. 119-126 ◽  
Author(s):  
Walton H Marsh ◽  
Benjamin Fingerhut ◽  
Elaine Kirsch
Keyword(s):  
Alkaline Phosphatase ◽  
Enzyme Activity ◽  
Standard Deviation ◽  
Enzyme Concentration ◽  
Mean Value ◽  
Colorimetric Analysis ◽  
Manual Method ◽  
Automated Method ◽  
The Mean ◽  
Standard Deviations

Abstract The alkaline phosphatase method of Kind and King was adapted to an automated recording colorimeter. The precision of the automated method (1 standard deviation as per cent of the mean value) was ±1.7 and for the manual method ±3.6 per cent. The color produced was proportional to the enzyme concentration by both methods, and recoveries of added phenol were satisfactory. In more than 150 serum specimens surveyed for enzyme activity, over 95 per cent of the results (2 standard deviations) of the 2 methods in the range 3.4-129 agree to within ±2.8 King-Armstrong units/1OO ml.

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