Coagulation Disorders in Fulminant Hepatitis Treated by Dialysis

1979 ◽  
Author(s):  
M. Morfini ◽  
F. Martinelli ◽  
S. Cinotti ◽  
S. Boncinelli ◽  
F. Mazzotta ◽  
...  
Keyword(s):  
Initial Level ◽  
Factor V ◽  
Heparin Infusion ◽  
Platelet Recovery ◽  
Normal Value ◽  
Factor Ii ◽  
Daily Dialysis ◽  
Prolonged Aptt ◽  
Low Levels ◽  
Very High

A young man, 28 years old, was admitted to Infectious Division with transaminases over 2500 U/ml, reduced cortical activity and decerebrate posturing. A prolonged APTT, Prothrombin below 15%, very low levels of Factor II, V, VII (5-20%). At III by S-2238 (17%), Antiplasmin (20%) and Plasminogen(5%) by S-2251, Preltallikrein by S-2302 (5%). Fibrinogen (70mg%) but very high VIII AHF(4.5U/ml}, VIII AGN (4.0U/ml) and VIII VWF (3.8U/ml) were recorded. After 3 daily dialysis sessions with polyacrilonitrile membrane (RP 6) a marked improvement was observed. The patient awoke while prothrombin and platelet recovery took place, fibrinogen,VIII AHF and Factor V rose over normal value to 600mg%, 7.5U/ml and 3U/ml rispectively. Antiplasmin, Plasminogen, PKK showed a slow but costant improvement. Unfortunatly a venous thrombosis and sepsis set in during the 2nd day after dialysis, with a rapid decrease of platelets. Heparin infusion 1 mg/kg b.w. was infused every 6 hrs. After 15days platelet returned to normal value and VIII AHF to initial level but it was still higher (4U/ml) than normal value after 2 mounths from recovery.

Studies on Blood Coagulation and Fibrinolysis in Patients Bitten by Bothrops jararaca (jararaca)

1990 ◽  
Vol 63 (03) ◽  
pp. 449-453 ◽  
Author(s):  
M Maruyama ◽  
Aura S Kamiguti ◽  
J L C Cardoso ◽  
Ida S Sano-Martins ◽  
Ana M Chudzinski ◽  
...  
Keyword(s):  
Blood Coagulation ◽  
Antithrombin Iii ◽  
Degradation Products ◽  
Factor V ◽  
Clinical Observations ◽  
Bothrops Jararaca ◽  
Factor Ii ◽  
Low Levels ◽  
Secondary Activation ◽  
Severe Coagulopathy

SummaryThe blood coagulation and the fibrinolytic systems of nine patients envenomed by Bothrops jararaca in São Paulo (Brazil) were studied. Five of the accidents were caused by young snakes (<50 cm). On admission, four patients had non-clotting and three partially-clotting blood. Fibrinogen levels were decreased due to the thrombin-like activity of the venom as expected. Consequent secondary activation of the fibrinolytic system was evident from the low levels of alpha-2-antiplasmin and the high titres of fibrin(ogen) degradation products. High titres of cross-linked fibrin fragment D (D-dimer) in seven patients together with decreased platelet counts and/or factor V, and/or factor VIII in some, suggests intrinsic thrombin formation as these factors are not consumed in the defibrinogenation induced by venom thrombin-like fractions such as Ancrod and Batroxobin. However, normal or increased levels of antithrombin III in all and normal levels of factor II in eight patients do not support this interpretation. The existence of variable concentrations of other proteins in the venom of B. jararaca such as botrocetin and thrombocytin isolated from B. jararaca and B. atrox or crotalocytin from Crotaliis horridus venom should be considered. Such proteins are known to activate factors V, VIII, XIII, and platelets without affecting prothrombin (factor II) and antithrombin III. Slower recovery of the haemostatic disturbances after antivenom administration to patients bitten by young snakes suggests a more severe coagulopathy in such accidents. This is supported by clinical observations.

Coagulation Findings in Rats with Experimental Hypersplenism and Their Changes after Splenectomy and after Administration of Adrenaline

1970 ◽  
Vol 23 (03) ◽  
pp. 593-600
Author(s):  
P Pudlák ◽  
I Farská ◽  
V Brabec ◽  
V Pospíšilová
Keyword(s):  
Factor Viii ◽  
Normal Control ◽  
Normal Values ◽  
Coagulation Factors ◽  
Factor Vii ◽  
Factor V ◽  
Thrombin Time ◽  
Factor Ii ◽  
Recalcification Time

Summary1. The following coagulation changes were found in rats with experimental hypersplenism: a mild prolongation of the recalcification time, shortened times in Quick’s test, a lowered activity in plasma thrombin time and shortened times in the partial thromboplastin test. Concentrations of factor II, V, VII (+X), VIII and X did not differ from those of normal control rats.2. The administration of adrenaline to hypersplenic rats induced the correction of the partial thromboplastin test, Quick’s test and plasma thrombin time to normal values. Concentrations of coagulation factors were not significantly changed. An increase was found in factor V.3. Splenectomy performed in hypersplenic rats was followed by a shortened recalcification time, a prolongation of the partial thromboplastin test and of the test with partial thromboplastin and kaolin. A prolongation was also observed in Quick’s test. Complete correction of plasma thrombin time was not observed. The concentration of factor VII increased.4. The administration of adrenaline to splenectomized rats with experimental hypersplenism did not induce any significant changes with the exception of a corrected plasma thrombin time and a decreased concentration of factor VIII.5. A different reaction of factor VIII to adrenaline in normal and hypersplenic rats is pointed out.

Spectrophotometric Assays of Prothrombin in Plasma of Patients Using Oral Anticoagulants

1979 ◽  
Vol 42 (04) ◽  
pp. 1296-1305 ◽  
Author(s):  
R M Bertina ◽  
W van der Marel-van Nieuwkoop ◽  
E A Loeliger
Keyword(s):  
Prothrombin Time ◽  
Vitamin K ◽  
Oral Anticoagulation ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Factor Xa ◽  
Factor V ◽  
Anticoagulant Treatment ◽  
Factor Ii ◽  
K Deficiency

SummaryTwo spectrophotometric assays for prothrombin have been developed and compared with a one stage coagulant and an immunological assay. One of these assays (called the XAPC assay) uses a combination of factor Xa, phospholipid, Ca2+ and factor V as activator of prothrombin, and measures only normal prothrombin. The second (the ECAR assay) uses Echis carinatus venom as activator. This assay measures both normal prothrombin and PIVKA II (protein induced by vitamin K antagonists/absence). Combination of the results obtained by the XAPC and ECAR assays provides rapid and reliable information on the degree of “subcarboxylation” of prothrombin (oral anticoagulation, vitamin K deficiency).For patients on long term anticoagulant treatment the prothrombin time (Thrombotest) shows better correlation with the ratio prothrombin/prothrombin plus PIVKA II (XAPC/ ECAR) than with the factor II concentration. For patients starting the anticoagulant treatment there is no correlation between the Thrombotest time and the XAPC/ECAR ratio.It seems doubtful that (a) spectrophotometric factor II assay(s) will be as useful as the prothrombin time in the control of oral anticoagulation.

Limits to Dominance?

2017 ◽  
Keyword(s):  
Communication Skills ◽  
Electoral System ◽  
Tony Blair ◽  
Prime Ministers ◽  
Margaret Thatcher ◽  
Capital Building ◽  
Low Levels ◽  
Very High ◽  
Over Time ◽  
Policy Vision

This chapter compares the leadership capital of two long-serving UK prime ministers: Tony Blair and Margaret Thatcher, treble election winners who held office for a decade. Mapping their capital over time reveals two very different patterns. Thatcher began with low levels of capital, building to a mid-term high and final fragile dominance, though her capital fell between elections. Blair possessed very high levels from the outset that gradually declined in a more conventional pattern. Both benefited from electoral dominance and a divided opposition, Thatcher’s strength lay in her policy vision while Blair’s stemmed from his popularity and communication skills. The LCI reveals that both prime ministers were successful without being popular, sustained in office by the electoral system. Towards the end of their tenures, both leaders’ continued dominance masked fragility, ousted when unrest in their parties and policy unpopularity eroded their capital.

The A6936G polymorphism of the endothelial protein C receptor gene is associated with the risk of unexplained foetal loss in Mediterranean European couples

2009 ◽  
Vol 102 (10) ◽  
pp. 656-667 ◽  
Author(s):  
Pascale Fabbro-Peray ◽  
Pierre Marès ◽  
Patrick Mismetti ◽  
Géraldine Lissalde-Lavigne ◽  
Éva Cochery-Nouvellon ◽  
...  
Keyword(s):  
Protein C ◽  
Pregnancy Loss ◽  
Receptor Gene ◽  
Coagulation Factor ◽  
Factor V ◽  
Endothelial Protein C Receptor ◽  
Foetal Loss ◽  
Factor Ii ◽  
Embryonic Loss ◽  
Factor V Gene

SummaryThe endothelial protein C receptor (EPCR) is expressed by trophoblast cells. Mid-gestation pregnancy loss is described in animals with a haemochorial placenta lacking EPCR. The A6936G allele of the EPCR gene (PROCR) may be associated with lower EPCR densities on trophoblasts, but data are lacking for its effect on the risk of pregnancy loss in humans. A 1:2 case-control study on unexplained pregnancy loss was nested in the NOHA First cohort: 3,218 case couples and 6,436 control couples were studied for PROCR A6936G, coagulation factor V gene (F5) G1691A and coagulation factor II gene (F2) G20210A polymorphisms. Ethnicity and time of pregnancy loss defined through biometry-based gestational ages (embryonic loss < 10th week ≥ foetal loss) were analysed. The PROCR A6936G allele, in mothers and fathers, was associated only with foetal loss in both Europeans and non-Europeans. Increasing probability levels of carrying a homozygous child were increasingly associated with the risk of foetal demise. The F5 G1691A and F2 G20210A alleles, only in mothers, were only and independently associated with foetal loss in Europeans. In our population, the PROCR A6936G allele describes women, but also men and thus couples, at risk for first unexplained foetal loss. This risk is independent of the foetal loss risk conferred to our local Mediterranean European women by the F5 G1691A and F2 G20210A alleles. Data confirm that the relationship between thrombophilias and pregnancy loss varies according to ethnicity and loss type.

scholarly journals Evaluation of the vulnerability of families assisted in Primary Care in Brazil

2012 ◽  
Vol 20 (5) ◽  
pp. 935-943 ◽  
Author(s):  
Tharsila Martins Rios da Silva ◽  
Márcia Regina Martins Alvarenga ◽  
Maria Amélia de Campos Oliveira
Keyword(s):  
Federal District ◽  
Family Development ◽  
Cross Sectional ◽  
Critical Dimensions ◽  
The Family ◽  
Low Levels ◽  
Access To Knowledge ◽  
The City ◽  
Very High ◽  
Structured Questionnaire

OBJECTIVE: to characterize the profiles of families in the area covered by a Primary Health Center and to identify those in a vulnerable situation. METHOD: this is an epidemiological, observational, cross-sectional and quantitative study. 320 home visits were made, defined by a random sample of the areas covered by the Urban Center 1 in the city of São Sebastião, in Brazil's Federal District. A structured questionnaire was used for data collection, elaborated based on the Family Development Index (FDI). RESULTS: there was a predominance of young families, women, and low levels of schooling. The FDI permitted the identification of families in situations of "high" and "very high" vulnerability. The most critical dimensions were: "access to knowledge" and "access to work". CONCLUSION: the study indicated the importance of greater investments in the areas of education, work and income, and highlighted the need for the use of a wider concept of vulnerability by the health services.

Homozygous and double heterozygous Factor V Leiden and Factor II G20210A genotypes predispose infants to thromboembolism but are not associated with an increase of foetal loss

2003 ◽  
Vol 90 (10) ◽  
pp. 628-635 ◽  
Author(s):  
Patrick Hundsdoerfer ◽  
Barbara Vetter ◽  
Brigitte Stöver ◽  
Christian Bassir ◽  
Tristess Scholz ◽  
...  
Keyword(s):  
Factor V Leiden ◽  
Individual Risk ◽  
Factor V ◽  
Thromboembolic Events ◽  
Foetal Loss ◽  
Asymptomatic Children ◽  
Factor Ii ◽  
The Individual ◽  
The Impact

SummaryProspective and controlled data about the individual risk profile in asymptomatic children with homozygous or double heterozygous risk genotypes for Factor V Leiden (FVL) and factor II (FII) G20210A are currently unavailable. The systematic and prospective observational study presented here was designed to determine the impact of the homozygous and double heterozygous FVL and FII G20210A genotypes on the prenatal and postnatal risk profiles of affected children. Risk infants and heterozygous controls were identified by screening of 85,304 neonates. Follow-up included the comparison of prenatal and postnatal development, ultrasonography of brain and kidneys, and a panel of independent determinants of thrombophilia. The numbers of identified or expected FVL homozygotes and double heterozygotes did not differ significantly (FVL: 116 ver-sus 91, p=0.08; FVL/FII: 94 versus 76, p=0.17), indicating the absence of a prenatal disadvantage. A prenatal advantage was suggested in FII homozygotes, whose identified number far exceeded the expected (19 versus 4, p=0.002). Clinical and/or imaging abnormalities indicated spontaneous thromboembolic events in 4 of 129 risk infants (3%) but in none of the 178 controls (p=0.02). Physical and neurological development was normal in both groups during the first 2 years of life. The risk genotypes appear to confer a significant predisposition for spontaneous thromboembolic events in infancy without impeding development within the first two years of life. Foetal risk genotypes do not cause an increased foetal loss rate. Moreover, homozygous FII G20210A appears to be associated with a prenatal advantage.

The economic and financial viability of sheltered employment centres

2019 ◽  
Vol 57 (9) ◽  
pp. 2261-2283
Author(s):  
Vera Gelashvili ◽  
Eva María Aguilar Pastor ◽  
María-Jesús Segovia-Vargas ◽  
Maria-del-Mar Camacho-Miñano
Keyword(s):  
Training Programs ◽  
Similar Response ◽  
Economic Returns ◽  
Content Type ◽  
Strategic Plans ◽  
Low Levels ◽  
The Difference ◽  
Practical Implications ◽  
Very High

Purpose The purpose of this paper is to investigate whether sheltered employment centers (CEEs) which have a higher rate of professionalization of their managers have better economic returns than those that have a lower one. Design/methodology/approach A questionnaire has been drawn up for their managers. After collecting the answers, an index of professionalization classifies the CEEs with managers of high, medium and low levels of professionalism. This index is then correlated with the main financial ratios of companies. Findings The results show that companies with the highest level of managers’ professionalization, on average, have higher economic returns than companies with medium and low rates, although the difference is not very high. This study is an important contribution to academic literature, as it is the first to examine the professionalization of CEE managers. Research limitations/implications Finally, this paper is not short of limitations. The number of responses is small but there are similar studies with similar response rates. Additionally, the scarcity of responses may suggest that there is a lack of interest about the utility of professionalization by some CEEs managers because, perhaps, they do not have the necessary competences to understand its importance in management. Practical implications This study has some main implications for stakeholders: first, CEEs must pay more attention to the professionalization of their management team, because professionalization can lead to meeting its goals and guaranteeing the firm’s growth. Second, training programs in skills and attitudes should be designed to strengthen these competencies. Moreover, managers of social firms should know that the establishment of strategic plans will be useful to identify new opportunities in the market. Social implications Given the important role of these social firms for the employment of people with disabilities, training programs should be promoted by government in order to ensure the professionalization of these companies. Originality/value This research is an important contribution to the literature on this subject because there are no studies about the level of professionalization of CEEs, companies that represent an important value for the economy of a country.

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