Streptokinase-Treatment Regimen in Childhood

1979 ◽  
Author(s):  
A.H. Sutor
Keyword(s):  
Treatment Regimen ◽  
Initial Dose ◽  
Blood Test ◽  
Initial Level ◽  
Capillary Blood ◽  
Bleeding Complications

From our experience treating 35 children with streptokinase we drew the following conclusions: 1. For children with shock syndromes due to sepsis we recommend streptokinase (SK-) therapy with 4 000 U/kg (within 15 to 30 min.) as initial dose and 1 000 U/kg (over 12 to 24 hours) as maintenance. 2. Before treatment and as control of the SK-action the determination of the plasminogen-proactivator (pp-) content with a capillary blood test was found to be very useful. 3. Insufficient decrease of PP-values (>3%) under SK-therapy indicates the possibility of hyperplasminemia, which can be connecte, with bleeding complications and which leads to inefficient exogenous fibinolysis. In this case SK-dose has to be increased. The cause of the hyperplasminemia may be underdosage of SK or an abnormally high initial level of pp.

scholarly journals Problems of Streptokinase Therapy in Childhood

1977 ◽  
Author(s):  
A.H. Sutor ◽  
V. Künzer
Keyword(s):  
Metabolic Disorders ◽  
Capillary Blood ◽  
Bleeding Complications ◽  
Age Group ◽  
Pediatric Age ◽  
Consumption Coagulopathy ◽  
Pediatric Age Group ◽  
Uremic Syndrome ◽  
Streptokinase Therapy

A generally accepted dosage regimen of streptokinase (SK) therapy is not available for the pediatric age group. In our experience with 35 children we found the determination of proactivator plasminogen (PP) by a capillary blood method very helpful for guidance of the initial and maintainance SK-therapy. Children with shock and consumption coagulopathy (due to gram negative sepsis, due to hypovolemia or due to metabolic disorders) have low PP-values and need an initial SK-dose of 4000 U/kg, followed continuously by 1000 U/kg/h for at least 24 hrs. Some children with local thromboses and the hemolytic-uremic-syndrome have high PP values which require an initial SK dose of 6000 U/kg and a maintenance dose of 1500 U/kg/h. PP-values during adequate SK-therapy drop to less than 3 %. Higher PP-values during SK-therapy indicate an underdosage of SK and require an increase of the SK-dose to prevent hyperplasminemia which may be followed by bleeding complications.

3300MiR-126-3P and MiR-223-3p in Prediction of Thrombotic Risk in Patients with Acute Myocardial Infarction and Primary Angioplasty, The Prague-18 Genetic Sub-study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Hromadka ◽  
Z Motovska ◽  
M Karpisek ◽  
O Hlinomaz ◽  
R Miklik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Antiplatelet Therapy ◽  
Arterial Disease ◽  
Smoking History ◽  
Bleeding Complications ◽  
Clinical Predictors ◽  
Thrombotic Risk ◽  
One Year

Abstract Background Balancing the intensity and duration of antiplatelet therapy according to thrombotic risk is a fundamental need in order to optimize therapy effectiveness and safety. Incorporation of new predictors in thrombotic risk stratification is therefore of a crucial importance for antiplatelet therapy net clinical benefit. Purpose The present analysis aimed to evaluate the relation of miR-126-3p and miR-223-3p, new markers of platelet activation, in order to facilitate prediction of recurrent thrombotic events after acute myocardial infarction (AMI). Method The analysis included 598 patients (age median 62 years, men 77.8%) randomized in the Prague-18 study (ticagrelor vs. prasugrel in AIM treated with primary PCI). During the study follow up, 40.6% of patients switched to clopidogrel. Determination of miR was evaluated 24 hours after admission; miR-126-3p and miR-223-3p were normalized by miR-423-3p and miR-150-5p. Quantitative determination of selected miRNAs was performed with a novel microRNA immunoassay method. Selected miRNAs were compared with key efficacy endpoints (cardiovascular death, nonfatal MI and stroke), stent thrombosis and all hemorrhagic events, and analysed using univariate and multivariate logistic regressions. Results Increased values of miR-223-3p were significantly related to the occurrence of combined ischemic endpoint within 30 days [OR (95% CI) 15.739 (2.066; 119.932) p=0.008] and within one year [3.175 (1.40; 7.186) p=0.006]. Decreased ratio of miR-126-3P/miR-223-3p was significantly related to the occurrence of combined ischemic endpoint within 30 days [0.137 (0.031; 0.609) p=0.009] and one year [0.372 (0.169; 0.819) p=0.014]. MiRNAs were identified as independent predictors even after adjustment for confounding clinical predictors (Study arm, Switch to Clopidogrel, Age, Men, BMI, Smoking, History of Hyperlipidemia, Hypertension, DM, MI, PCI, CABG, Chronic heart failure, Chronic renal failure, Peripheral arterial disease, LBBB, RBBB, TIMI <3 after PCI, Number of diseased vessels >1, Stem disease, Suboptimal of failure of PCI, Time to hospital). Adjusted ORs (95% CI) are 11.828 (1.472; 98.011), p=0.022 and 2.394 (1.021; 5.610), p=0.045 for increased value of miR-223-3p and the occurrence of combined ischemic endpoint within 30 days and one year respectively; 0.151 (0.030; 0.757), p=0.022 and 0.407 (0.179; 0.925), p=0.032 for decreased ratio of miR-126–3P/miR-223-3p and the occurrence of combined ischemic endpoint within 30 days and one year respectively. No association between miRNA and bleeding complications was identified. Conclusion The miR-223-3p and miR-126-3p to miR-223-3p ratio are strong independent predictors of thrombotic ischemic events and can be used to stratify patients post AMI.

Ferritin concentrations in plasma from capillary (finger prick) blood and venous blood compared.

1983 ◽  
Vol 29 (5) ◽  
pp. 871-873 ◽  
Author(s):  
L A Mejía ◽  
F E Viteri
Keyword(s):  
Blood Plasma ◽  
Close Association ◽  
Venous Blood ◽  
Capillary Blood ◽  
Ferritin Concentration ◽  
Antecubital Vein ◽  
Finger Prick ◽  
Adults And Children ◽  
Venous Plasma

Abstract Investigating the feasibility and validity of determining plasma ferritin concentration in blood obtained by finger prick, we studied 29 adults (ages 21-49 years) and 35 children (ages 14-66 months). Blood was sampled simultaneously in the same subject from both the antecubital vein (venous blood) and by finger pricking (capillary blood). The plasma was obtained by centrifugation. Ferritin concentration was determined by immunoradiometric analysis. Ferritin concentration in plasma from capillary blood was significantly higher than in venous plasma (p less than 0.01). This difference was more marked in children. The correlation between ferritin from the two blood sources was highly significant (r2 = 0.945 and 0.994 for samples from adults and children, respectively), and the slopes of the respective regression lines in both children and adults were significantly different from 1 (p less than 0.0001). We conclude that, despite the close association between the two procedures, the determination of ferritin concentration in capillary blood plasma overestimates the concentration of ferritin in venous blood plasma.

scholarly journals Physiological and perceptual responses to three consecutive official matches in female boxer. A case study

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Zbigniew Obmiński ◽  
Dariusz Turowski
Keyword(s):  
Creatine Kinase ◽  
Time Profile ◽  
Serum Creatine Kinase ◽  
Capillary Blood ◽  
Short Term ◽  
Blood Indices ◽  
Physiological Cost ◽  
Capillary Blood Sampling

Summary Study aim: The purpose of this study was to assess the physiological cost of three consecutive official boxing fights played during a 3-day tournament and two non-contact specific drills against handheld pads of the same time-profile as the contest, 4 × 2 minutes with 1-minute intervals between them. This assessment was based on the determination of selected hormones and metabolites in the blood sampled directly prior to the contests and throughout short-term post-contest recovery. Material and methods: A female amateur boxer was enrolled on the study during a 3-day Polish Boxing Championship, where one match was played on each day. The timing of capillary blood sampling during each match and the drill was as follows: 10 minutes prior to the effort, and 3 and 30 minutes after its completion. Cortisol (C), testosterone (T), and glucose (G) were determined in the serum, while lactate (LA) was determined in the blood. In addition, prior to each effort, serum creatine kinase (CK) and urea (U) was determined. Directly after each effort, the perception of fatigue (PF) was rated. Results: G, C, and T during official matches were significantly higher than those during non-contact drills. Post-event G, C, T, and LA were higher compared to pre-event values. Conclusions: An official boxing match produced higher stress than a drill of the same time-profile and similar modality. Changes in blood indices corresponded well with the perception of fatigue.

Activated Recombinant Factor VII (rFVIIa/NovoSeven®) in the Treatment of Bleeding Complications Following Hematopoietic Stem Cell Transplantation (HSCT).

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1135-1135 ◽  
Author(s):  
Benjamin Brenner ◽  
Markus Pihusch ◽  
Andrea Bacigalupo ◽  
Jeff Szer ◽  
Mario von Depka Prondzinski ◽  
...  
Keyword(s):  
Adverse Events ◽  
Initial Dose ◽  
Factor Vii ◽  
Bleeding Complications ◽  
Controlled Study ◽  
Severe Bleeding ◽  
Trial Period ◽  
Hematopoietic Stem ◽  
Coagulation Parameters ◽  
Transfusion Requirements

Abstract HSCT is a common treatment of hematological or oncological disorders. Many HSCT-associated complications, including prolonged aplasia, infection and graft-versus-host disease (GVHD) predispose to bleeding, resulting in increased morbidity and mortality. Platelet concentrates, fresh frozen plasma, antifibrinolytic agents or prothrombin complex concentrates are often ineffective. Although licensed for use in hemophilia pts with inhibitors, rFVIIa has been reported to be effective for the treatment of bleeding related to thrombocytopenia, thrombasthenia and other coagulation disorders. We conducted a multicenter, randomized, double-blind, placebo-controlled trial to evaluate the efficacy and safety of rFVIIa in treatment of bleeding from days 2 to 180 after HSCT (F7BMT-1360 trial). Patients received rFVIIa (40, 80, 160 μg/kg) or placebo every 6h for 36h and were followed up for 96h after the initial dose. Exclusion criteria were recent thromboembolic events, atherosclerotic disease, DIC, thrombotic microangiopathy, venoocclusive disease and active AML (M3, M4, M5). The primary efficacy endpoint was the change in bleeding from 0h to 38h after initial dose. Secondary endpoints were transfusion requirements, change of coagulation parameters, and adverse events (AEs). One hundred patients (64 m; 36 f; 97 allogeneic; 3 autologous; 67 PBSC; 30 bone marrow; 2 cord blood; 1 unknown) with moderate or severe bleeding were included (38 lower GI; 26 hemorrhagic cystitis; 14 upper GI; 7 pulmonary; 1 intracerebral; 14 other). 80 μg/kg rFVIIa was effective, however no significant reduction in bleeding was seen at 160 μg/kg. There were no differences in transfusion requirements and changes in coagulation parameters across dose groups. Thirteen serious adverse events (SAEs) were reported within the trial period; there was no apparent drug or dose-related trend in the type or number of SAEs. One thromboembolic SAE (catheter thrombosis, 160 μg/kg) was observed within the trial period (2 days after last dosing) and two thromboembolic SAEs (cerebral infarction, 80 μg/kg; myocardial infarction, 40 μg/kg) were reported 4 and 14 days after last dosing. In this first controlled study on the use of rFVIIa after HSCT we found a significant effect of 80 μg/kg rFVII versus the standard hemostatic treatment. The diversity of the hemostatic disturbances and the heterogeneity of the patient population may have contributed to the lack of an increasing effect with increased dose. No safety issues were identified. Further trials with higher numbers of patients should focus upon optimizing the dose regimen of rFVIIa and on severe bleeding complications Bleeding status 38h after initial dose Treatment Gp N Stopped Decreased Unchanged/worse Cumulative odds ratio 97.1% CI p All data based on ITT. p&lt;0.029 considered sig. Overall treatment effect: p=0.003. *Status unknown for 2 pts Placebo 22 5 (23%) 8 (36%) 9 (41%) 1.00 - - 40μg/kg 20 6 (30%) 4 (20%) 10 (50%) 0.94 [0.24; 3.64] 0.923 80μg/kg 26 14 (54%) 7 (27%) 5 (19%) 4.20 [1.05; 16.84] 0.021 160μg/kg 30 4 (13%) 9 (30%) 17 (57%) 0.54 [0.16; 1.83] 0.269 Total 98* 29 (30%) 28 (29%) 41 (42%) - - -

An Extremely Simple and Fast Microlitre Method for the Determination of Total Carbon Dioxide in Biological Samples

1985 ◽  
Vol 22 (5) ◽  
pp. 509-513 ◽  
Author(s):  
G J Van Stekelenburg ◽  
C Valk ◽  
M J G Van Wijngaarden-Penterman
Keyword(s):  
Carbon Dioxide ◽  
Biological Fluids ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Capillary Blood ◽  
Total Carbon ◽  
Blood Gas ◽  
Carbon Dioxide Content ◽  
Simple Method

For those clinical laboratories equipped with a microprocessor-controlled gas analyser, an extremely simple method is described for the determination of the total carbon dioxide content in various biological fluids. Since this method needs only 20 μL of blood plasma or is less dependent on the original total carbon dioxide content, it is especially suited for paediatric purposes. With our procedure the time necessary for one determination equals the time for one capillary blood gas analysis.

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