Antimicrobial, Anticoagulant and Anticancer Effects of Arum Palaestinum Flowers Extracts

Background: Wild plants are amply utilized in traditional medicine and folkloric food worldwide. Arum palaestinum Boiss. (AP) is one of the wild Palestinian plants which leaves have a long history in the Middle Eastern countries as food and medicine. Herby, the current study aimed to evaluate the antimicrobial, coagulation cascade activities, and anticancer effects of (AP) flowers extract Methods: The aqueous extract of (AP) flowers was screened on its antimicrobial activity using microdilution assay against eight pathogens. While, prothrombin time, activated partial thromboplastin time, and thrombin time tests were measured utilizing standard hematological methods. And Anti cancer effect was assessed by using Parameters of cell cycles and alph feta protein level that were investigated for (AP) flowers fractionated with aqueous, DMSO, and methanol Results: The antimicrobial screening results revealed that the aqueous extract of (AP) has strong antibacterial effects against P. vulgaris and E. faecium compared with Ampicillin with MIC values of 6.25, 6.25 and 18 mg/ml, respectively. The aqueous extract of (AP) showed anticoagulant activity with significant prolonged results in aPTT and TT tests at high concentrations (50 mg/ml and 25 mg/ml) and slightly prolonged results in the PT test at a high concentration (50 mg/ml). The anticancer results indicate a delay in cell cycle through decreased the cell proliferation rate following effects of the AP fractions. The delay in the S phase was in favor of the water fraction. Water and DMSO fractions while maintained the cells in the G2-M phase similar to the DOX, the flower extract in methanol accelerated the cells in the G2-M phase suggesting that (AF) flower extracts have anti-cancer properties. At the same time Aqueous extract decreased HCC aFP to 1.55-fold (P=0.0008). While DMSO and methanolic extract had no significant effects on HCC aFP levels, compared to control untreated cells of 2519.16 ± 198.1 ng/ml. This data show that (AF) aqueous solution is potent inhibitor of alpha-fetoprotein secretion (P-value <0.05), which indicates its anti-carcinogenic effects Conclusion: These results showed that the aqueous extract of (AP) plant possesses bioactive components with antibacterial and anticoagulant properties, which may be exploited in the treatment of infectious diseases and blood coagulation disorders.

DENYING TOTAL HIP ARTHROPLASTY IN SMOKERS, PATIENTS WITH ALCOHOL ABUSE OR IN PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUSES. WHY?

Nowadays total hip arthroplasty (THA) is one of the most successful surgical procedures in the world and the number of procedures performed is growing every year. However, its success largely depends on the absence of postoperative complications. Among the risk factors affecting the occurrence of postoperative complications are smoking, alcohol abuse, drug abuse, human immunodeficiency viruses (HIV), obesity, anemia, diabetes mellitus, malnutrition, rheumatoid arthritis, cardiovascular diseases, renal failure and dialysis, depression and anxiety. In the presented manuscript, such factors as HIV, smoking and alcohol abuse were considered. In smokers, bone regeneration slows down due to impaired bone metabolism and a slowdown in vascular recovery. Alcohol abuse affects human immunity, inhibiting T-helper cells, and also causing blood coagulation disorders. Alcohol abuse increases the risk of hospital complications, surgery related complications and general medical complications. Smoking can increase the risk of septiccomplications (lower respiratory tract infection, sepsis, urinary tract infection), myocardial infarction, risk of aseptic loosening of implants. Mortality was also higher in smokers compared to nonsmokers. HIV increases bone fragility, debilitation, rate of cardiovascular diseases and decreases the number of CD4+ cells in the blood, which directly affects the risk of periprosthetic joint infections and revision. All three factors increase the patient's lengthof stay in the hospital after THA. Currently, recommendations have been developed for preventive measures that need to be taken to reduce the risk of postoperative complications by performing primary THA. According to the recommendations, quitting smoking and drinking alcohol 4 weeks before THA will significantly reduce the risk of postoperative complications. For HIV-positive patients, antiretroviral therapy and subsequent assessing the viral load arerequired prior to THA. Preoperative care in this category of patients, undergoing primary THA, can reduce the risk of complications.

Comparative analysis of the results of non-activated thromboelastometry and thromboelastography of venous blood in pregnant women in health and disease

Цель исследования: сравнительный анализ неактивированной тромбоэластографии (ТЭГ) и тромбоэластометрии (ТЭМ) в диагностике нарушений свертывающей системы крови при беременности. Материалы и методы. Обследованы 2 группы женщин в III триместре беременности: 44 женщины с привычным невынашиванием беременности в анамнезе (основная группа) и 35 условно здоровых беременных (контрольная группа). Пациентки основной группы получали профилактику тромботических осложнений низкомолекулярными гепаринами (НМГ). Выполнено стандартное исследование свертывающей системы крови: подсчет тромбоцитов, определение концентрации фибриногена, протромбинового времени (ПТ) по Квику, активированного частичного тромбопластинового времени (АЧТВ), тромбинового времени (ТВ), неактивированная ТЭГ и ТЭМ. Результаты. Значимых различий в значениях фибриногена, АЧТВ, ПТ между группами выявлено не было. В обеих группах при ТЭГ/ТЭМ исследовании установлено укорочение интервалов времени свертывания и времени образования сгустка, увеличение плотности сгустка, что соответствует протромботическим изменениям системы гемостаза при беременности. Определены значения показателей неактивированной ТЭГ/ТЭМ в III триместре физиологически протекающей беременности. Заключение. Методы неактивированной ТЭГ и ТЭМ имеют высокую информативность в диагностике нарушений системы гемостаза и могут быть использованы для контроля состояния свертывающей системы крови при беременности наряду с активированными стандартизованными тестами. Objectives: to conduct a comparative analysis of non-activated thromboelastography (TEG) and thromboelastometry (TEM) in the diagnosis of blood coagulation disorders during pregnancy. Patients/Methods. We examined 2 groups of women in III trimester of pregnancy: 44 women with a history of habitual miscarriage (the main group) and 35 relatively healthy pregnant women (the control group). Patients of the main group received prophylaxis of thrombotic complications with low molecular weight heparins (LMWH). A standard study of the blood coagulation system with platelet count, determination of fibrinogen concentration, prothrombin time (PT) by Quick, activated partial thromboplastin time (APTT), thrombin time (TT), non-activated thromboelastography (TЕG) and thromboelastometry (TEM) was performed. Results. There were no signifi cant differences in fi brinogen level, APTT, PT between the groups. In both groups, TEG/TEM study found shortening of the clotting time intervals and clot formation time, an increase in clot density, which corresponds to hemostasis prothrombotic changes during pregnancy. Reference ranges of nonactivated TEG/TEM parameters in III trimester of physiological pregnancy were determined. Conclusions. Methods of non-activated TEG/TEM are highly informative in the diagnosis of hemostasis disorders and can be used, together with activated standardized tests, to monitor blood coagulation during pregnancy.

Platelet Receptor Activity for Predicting Survival in Patients with Intracranial Bleeding

Blood coagulation disorders in patients with intracranial bleeding as a result of head injuries or ruptured aneurysms are a diagnostic and therapeutic problem and appropriate assessments are needed to limit CNS damage and to implement preventive measures. The aim of the study was to monitor changes in platelet aggregation and to assess the importance of platelet dysfunction for predicting survival. Platelet receptor function analysis was performed using the agonists arachidonic acid (ASPI), adenosine diphosphate (ADP), collagen (COL), thrombin receptor activating protein (TRAP), ristocetin (RISTO) upon admission to the ICU and on days 2, 3, and 5. On admission, the ASPI, ADP, COL, TRAP, and RISTO tests indicated there was reduced platelet aggregation, despite there being a normal platelet count. In ‘Non-survivors’, the platelet response to all agonists was suppressed throughout the study period, while in ‘Survivors’ it improved. Measuring platelet function in ICU patients with intracranial bleeding is a strong predictor related to outcome: patients with impaired platelet aggregation had a lower 28-day survival rate compared to patients with normal platelet aggregation (log-rank test p = 0.014). The results indicated that measuring platelet aggregation can be helpful in the early detection, diagnosis, and treatment of bleeding disorders.

The history and future of hemostasis research (to the Anniversary of Kirov Research Institute of Hematology and Blood Transfusion FMBA of Russia).

В настоящей статье освещаются некоторые этапы становления гемостазиологии как научного направления. Отдельная составляющая работы посвящена истории развития данного раздела медицины, достижениям выдающихся отечественных ученых; освещены ближайшие и отдаленные перспективы научных исследований. Накопленный опыт позволяет авторам надеяться на дальнейшее совершенствование знаний по вопросам свертывания крови и становление специальности «гемостазиология» в Российской Федерации для оказания профессиональной и пациент-ориентированной помощи больным различными заболеваниями, сопровождающимися нарушениями гемокоагуляции. The article highlights some of the stages in hemostasiology development as a scientific direction. A certain part of the work is devoted to the evolution of this branch of medicine, to the achievements of eminent domestic researchers, highlighted the immediate and further prospects of scientific research. The lessons learned allows to hope for advancing knowledge on the blood coagulation issues and the formation of the specialty “hemostasiology” in the Russian Federation to the professional and patient-oriented care of different patient groups accompanied by blood coagulation disorders.

DISTÚRBIOS DA COAGULAÇÃO EM PACIENTES OBSTÉTRICAS INFECTADAS PELO SARS-COV-2 (COVID-19)

Introdução: A atual pandemia da COVID-19, causada pelo novo coronavírus SARSCoV-2, teve rápida disseminação e resultou em inúmeros casos fatais. A coagulopatia é uma das principais complicações dessa doença, sendo possível a ocorrência em qualquer paciente infectado pelo vírus, um dos grupos de risco, as pacientes obstétricas, denota maior atenção, devido às alterações coagulativas e hemostáticas já esperadas neste grupo. Objetivo: Analisar a ocorrência de coagulopatia devido à COVID-19 em pacientes obstétricas. Material e métodos: Após o levantamento de dados nas bases PUBMED, LILACS, SciELO e MEDLINE, utilizando os seguintes descritores: Coagulopathy; Covid-19; Sars-CoV-2; Blood Coagulation Disorders; Pregnant Women; Coronavírus Infections, 17 artigos foram selecionados para compor esta revisão, sendo 10 Artigos de Revisão, 4 Relatos de Casos e 3 Artigos Originais. Resultados: A infecção pela COVID19 causa uma resposta inflamatória exagerada, com a presença da chamada “tempestade de citocinas”. Esse estado hiperinflamatório pode facilitar o surgimento de microtrombos em diversos órgãos, como fígado e pulmão. A inflamação, por si só, tende a favorecer a presença da hipercoagulabilidade, sobretudo, entre os casos mais severos. Nas gestantes, submetidas às alterações fisiológicas desse período, caracterizado por um estado hipercoagulativo e hipofribinolítico, associado a uma supressão imunológica natural, evidencia-as como um grupo à parte dentro dessa temática, esse com maior possibilidade de distúrbios coagulativos severos, como a formação de microtrombos placentários e níveis elevados de D-dímero, o que indica piores desfechos maternos e fetais. Conclusão: A hipercoagulabilidade aumenta a mortalidade da COVID-19, sendo o grupo de gestantes mais suscetível a esse agravo devido às alterações causadas durante esse momento, piorando seu prognóstico. A própria carência de estudos e protocolos, portanto, evidencia a necessidade de buscar ainda mais dados sobre essa relação, a fim de prover o melhor manejo a tais pacientes.

Current trends in blood coagulation studies

Blood coagulation occurs in flow or stasis conditions, it involves components of cell hemostasis and enzymatic cascades of reactions; it serves to stop bleeding yet it can lead to life-threatening blood thrombi. Despite the fact that a complete list of coagulation proteins was well known for decades, in recent years numerous facts has accumulated about its structure and regulation. All that has led to the creation of new methods for diagnosing of blood coagulation disorders and methods for their correction. Congenital and acquired coagulation disorders are still an acute clinical problem. This review shows modern ideas about the structure and functioning of the blood coagulation system in various conditions.

Effect of Selected Diets/Xanthone Derivatives on Morphotic Image of Bone Marrow and Other Tissues

Introduction: The diet as well as some xanthone derivatives can influence the processes occurring in the bone marrow, which is a hematopoietic organ and plays an important role in the immune system. Changes in the proportions of individual cell lines may lead to illnesses such as anemia or blood coagulation disorders. Aim: The aim of the study is to identify the effect of selected xanthone derivatives and high-fat diet on the morphological construction of individual cell lines in the bone marrow (erythrocyte line, myeloblastic line, monocytic line, megakaryocytic line, lymphoid line). Material and Methods: The studies were carried out on 4 groups of CD1 mice (n = 10): control (c), diabetes induced by a high-fat diet (f) and two derivatives of xanthone (gr. 1 and 2). Five-week-old animals received a standard or an enriched in fat diet for another 5 weeks. After decapitation of animals the bone marrow smear was prepared. The stained preparations were observed under a microscope and hematopoietic cells were counted. Results: Based on the results and preliminary statistical treatment, it was found that there is a relationship between the diet used and changes in the proportion of cells of particular hematopoietic lines. The strongest changes were observed in the number of lymphocytes. The control group has statistically significantly more, compared to the group receiving the fat diet. It was also found that there is a relationship between the dietary xanthone derivatives used and the changes in the proportion of cells of particular hematopoietic lines. Conclusion: The use of a high-fat diet and xanthone derivatives can have a significant impact on the change in the number of lymphocytes in the bone marrow.

Hematological Phenotype of COVID-19-Induced Coagulopathy: Far from Typical Sepsis-Induced Coagulopathy

Background: Blood coagulation disorders commonly occur with severe coronavirus disease 2019 (COVID-19). However, there is only limited evidence on differentiating the pattern of the hemostatic parameters from those of typical sepsis-induced coagulopathy (SIC). Methods: To elucidate the specific pattern of coagulopathy induced by COVID-19 pneumonia, this retrospective, observational study targeted consecutive adult patients with COVID-19-induced acute respiratory distress syndrome (ARDS) and compared hemostatic biomarkers with non-COVID-19-induced septic ARDS. Multilevel mixed-effects regression analysis was performed and Kaplan–Meier failure curves were constructed. Results: We enrolled 24 patients with COVID-19-induced ARDS and 200 patients with non-COVID-19-induced ARDS. Platelet count, antithrombin activity, and prothrombin time in the COVID-19 group were almost within normal range and time series alterations of these markers were significantly milder than the non-COVID-19 group (p = 0.052, 0.037, and 0.005, respectively). However, fibrin/fibrinogen degradation product and D-dimer were significantly higher in the COVID-19 group (p = 0.001, 0.002, respectively). COVID-19 patients had moderately high levels of thrombin–antithrombin complex and plasmin-alpha2-plasmin inhibitor complex but normal plasminogen activator inhibitor-1 level. Conclusions: The hematological phenotype of COVID-19-induced coagulopathy is quite different from that in typical SIC characterized by systemic hypercoagulation and suppressed fibrinolysis. Instead, local thrombus formation might be promoted in severe COVID-19.