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Hematocrit
Terms modified by Hematocrit Selected AbstractsCombined repeated dose and reproductive/developmental toxicity screening test of the nitrophenolic herbicide dinoseb, 2- sec -butyl-4,6-dinitrophenol, in ratsENVIRONMENTAL TOXICOLOGY, Issue 2 2008Mariko Matsumoto Abstract In a combined repeated dose toxicity study with reproduction/developmental toxicity screening test, Crj:CD(SD)IGS rats were dosed with dinoseb, 2- sec -butyl-4,6-dinitrophenol, by gavage at 0 (vehicle), 0.78, 2.33, or 7.0 mg/kg bw/day. Six males per group were dosed for a total of 42 days beginning 14 days before mating. Twelve females per group were dosed for a total of 44,48 days beginning 14 days before mating to day 6 of lactation throughout the mating and gestation period. Recovery groups of six males per group and nonpregnant six females per group were dosed for 42 days followed by a 14-day recovery period. No deaths were observed in males of any dose group or in females of the recovery groups. At 7.0 mg/kg bw/day, eight females died and two animals were moribund during late pregnancy, and a significant decrease in body weight gain was found in both sexes. Hematocrit was significantly higher at 0.78 mg/kg bw/day and above in the main group males at the end of administration period. Reduction in extramedullary hematopoiesis in the spleen was significant at 2.33 mg/kg bw/day in the main group females. Sperm analysis revealed a decrease in sperm motility and an increase in the rates of abnormal sperm, abnormal tail, and abnormal head at 7.0 mg/kg bw/day. A number of dams delivered their pups and of dams with live pups at delivery was significantly lowered in the 7.0 mg/kg bw/day group. Based on these findings, the LOAEL for males and NOAEL for females were 0.78 mg/kg bw/day, and the NOAEL for reproductive/developmental toxicity was considered to be 2.33 mg/kg bw/day. © 2008 Wiley Periodicals, Inc. Environ Toxicol, 2008. [source] Mitigating stress effects during transportation of matrinxã (Brycon amazonicus Günther, 1869; Characidae) through the application of calcium sulfateJOURNAL OF APPLIED ICHTHYOLOGY, Issue 2 2009F. Bendhack Summary This study verified the effects of CaSO4 on physiological responses of the tropical fish matrinxãBrycon amazonicus (200.2 ± 51.1 g) in water containing CaSO4 after a 4-h transportation at concentrations of: 0, 75, 150, and 300 mg L,1. Blood samples were collected prior to transportation (initial levels), immediately after packaging, at arrival, and 24 h and 96 h after transportation (recovery). Cortisol levels increased after packaging (118.2 ± 14.2 ng ml,1), and decreased slightly after transportation in water containing CaSO4 (106.8 ± 14.1), but remained higher than initial levels (21.0 ± 2.6 ng ml,1). Fish kept at 150 mg L,1 CaSO4 reached the pre-transportation levels at 24 h of recovery. Blood glucose increased after transportation in all treatments (8.2 ± 0.2 mmol L,1) and declined after full recovery to values below initial levels (4.8 ± 0.1 mmol L,1). Chloride levels did not change in CaSO4 treatments; serum sodium concentrations decreased after packaging and after transportation. Serum calcium levels did not differ among treatments, but decreased after packaging and increased at 96 h of recovery. Hematocrit and the number of red blood cells were higher in all treatments after packaging and arrival, except in fish exposed to 300 mg L,1 CaSO4. Mean corpuscular volume increased in 75 mg L,1 CaSO4, which reached the higher VCM after transportation. Hemoglobin levels increased only after transportation, regardless of calcium sulfate levels. Handling before transportation and transportation itself were both stressful to fish; calcium sulfate at concentrations tested in the present work had a moderate influence in the reduction of stress responses. [source] Clinical Efficacy and Safety of Recombinant Canine Erythropoietin in Dogs with Anemia of Chronic Renal Failure and Dogs with Recombinant Human Erythropoietin-Induced Red Cell AplasiaJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2004John F. Randolph The efficacy and safety of recombinant canine erythropoietin (rcEPO) therapy was evaluated in 19 dogs with anemia of chronic renal failure (group 1) and 6 dogs with chronic renal failure and recombinant human erythropoietin (rhEPO)-induced red cell aplasia (group 2). Hematocrit (Hct) and absolute reticulocyte count (ARC) were monitored weekly for the first 8 weeks, CBC (including ARC) and serum iron profiles were evaluated monthly, and serum biochemical analyses were performed every 2 months for 6 (group 2) to 12 (group 1) months. For group 1 dogs, median Hct and ARC increased significantly during the 1st week of rcEPO treatment, and median Hct was sustained at >35% after week 5. In contrast, median Hct and ARC for group 2 did not change significantly with rcEPO treatment, even with doses greater than those used in group 1. Nevertheless, 2 (33%) of the 6 dogs in group 2 developed erythroid hyperplasia, reticulocytosis, and increases in Hct with rcEPO treatment. Although median systolic blood pressure did not change significantly in either group, 5 dogs developed systolic blood pressures a 180 mm Hg during the study. Appetite and energy level improved in most group 1 dogs with increases in Hct. Recombinant cEPO stimulated erythrocyte production in dogs with nonregenerative anemia secondary to chronic renal failure without causing the profound erythroid hypoplasia that can occur in rhEPO-treated dogs. Unfortunately, rcEPO was not as effective in restoring erythrocyte production in dogs that had previously developed rhEPO-induced red cell aplasia. [source] Effects of Nigella orientalis and N. segetalis fixed oils on blood biochemistry in ratsPHYTOTHERAPY RESEARCH, Issue 1 2006G. Kökdil Abstract Nigella orientalis and N. segetalis fixed oils were administered orally (1 mL/kg/day) to Wistar Kyoto rats for 4 weeks. The effects of the oils on biochemical parameters were compared with a control group that received distilled water under identical conditions. LDL-cholesterol level was decreased significantly in both oil groups while serum total cholesterol and VLDL-cholesterol were decreased significantly following administration of only N. orientalis fixed oil when compared with the control group. The HDL-cholesterol levels were increased significantly in both oil groups. N. orientalis fixed oil significantly reduced Aspartateaminotransferase (AST), Alkaline Phosphatase (ALP), bilirubin and urea levels in rats. There was an increase in the albumin, uric acid and mean corpuscular volume (MCV) concentrations, while the mean corpuscular hemoglobin concentration (MCHC) and RDW (red cell distribution width) levels decreased significantly. In N. segetalis fixed oil treated rats, the levels of ALP, Blood Urea Nitrogen (BUN), MCHC, RDW were decreased significantly, whereas a significant increase was found in albumin, fibrinogen, Hematocrit (HCT) and MCV levels. The effects of 4 weeks oral intake of N. orientalis and N. segetalis fixed oils on blood malondialdehyde (MDA) and total antioxidant status (TOS) were also investigated in rats. The study showed that the oils had no significant effect on MDA production. N. orientalis and N. segetalis fixed oils caused a significant increase in the total antioxidant status in rats. Copyright © 2006 John Wiley & Sons, Ltd. [source] Prediction of hyperbilirubinaemia in the healthy term newbornACTA PAEDIATRICA, Issue 2 2001X Carbonell The aim is to establish the correlation between transcutaneous bilirubin (TCB) and serum bilirubin (TSB) and its predictive value for significant hyperbilirubinaemia ,290 mcmol/L (17mg/dL). We studied a total of 2004 healthy full-term newborns, weight 3.230g ± 491g; 90% received breast milk. The study was performed in two phases. In the first phase (610 newborns), the following tests were carried out: hematocrit and bilirubin in umbilical cord blood; TCB at 24 h, 48 h and between 60 h and 96 h at the forehead and over the sternum; TSB was measured along with this last test. In the second phase (1394 newborns), the predictive value of TCB and TSB was validated. The incidence of bilirubin >290 mcmol/L was 2.95% and 3.2%. The correlation between TSB and TCB is high (n= 996; r = 0.92; y = 5.916 + 0.804x; p < 0.000). There was a better correlation between TCB and TSB with sternal compared to forehead determination (< 24 h: 0.81 vs 0.77; 24,48 h: 0.887 vs 0.83; and >48 h: 0.94 vs 0.83). The study showed the scant sensitivity of umbilical cord blood bilirubin and good predictive value at 24 h of TSB > 102 mcmol/L (6mg/dL) and at 48 h of TSB > 154 mcmol/L (9mg/dL) and TCB > 13 (equivalent to 154 mcmol/L). Conclusion: There is a good correlation between TCB and TSB. In infants with TSB 102 mcmol/L at 24 h or TSB > 154 mcmol/L or transcutaneous readings > 13 h at 48 h, a TSB test must be performed after 48 h of life. [source] Effect of Normal Saline Infusion on the Diagnostic Utility of Base Deficit in Identifying Major Injury in Trauma PatientsACADEMIC EMERGENCY MEDICINE, Issue 12 2006Richard Sinert DO Abstract Background Base deficit (BD) is a reliable marker of metabolic acidosis and is useful in gauging hemorrhage after trauma. Resuscitation with chloride-rich solutions such as normal saline (NS) can cause a dilutional acidosis, possibly confounding the interpretation of BD. Objectives To test the diagnostic utility of BD in distinguishing minor from major injury after administration of NS. Methods This was a prospective observational study at a Level 1 trauma center. The authors enrolled patients with significant mechanism of injury and measured BD at triage (BD-0) and at four hours after triage (BD-4). Major injury was defined by any of the following: injury severity score of ,15, drop in hematocrit of ,10 points, or the patient requiring a blood transfusion. Patients were divided into a low-volume (NS < 2L) and a high-volume (NS , 2L) group. Data were reported as mean (±SD). Student's t- and Wilcoxon tests were used to compare data. Receiver operating characteristic (ROC) curves tested the utility of BD-4 in differentiating minor from major injury in the study groups. Results Four hundred eighty-nine trauma patients (mean age, 36 [± 18] yr) were enrolled; 82% were male, and 34% had penetrating injury. Major-(20%) compared with minor-(80%) injury patients were significantly (p = 0.0001) more acidotic (BD-0 mean difference: ,3.3 mmol/L; 95% confidence interval [CI] =,2.5 to ,4.2). The high-volume group (n = 174) received 3,342 (±1,821) mL, and the low-volume group (n = 315) received 621 (±509) mL of NS. Areas under the ROC curves for the high-volume (0.63; 95% CI = 0.52 to 0.74) and low-volume (0.73; 95% CI = 0.60 to 0.86) groups were not significantly different from each other. Conclusions Base deficit was able to distinguish minor from major injury after four hours of resuscitation, irrespective of the volume of NS infused. [source] Serum and 24-hour Urine Analysis in Adult Cyanotic and Noncyanotic Congenital Heart Disease PatientsCONGENITAL HEART DISEASE, Issue 3 2009Efrén Martínez-Quintana MD ABSTRACT Introduction., Glomerulopathy is a complication of congenital heart disease patients. The risk of developing renal impairment is particularly high in cyanotic patients. Objective., The aim of this study was to determine the prevalence of renal dysfunction and microalbumiuria in adult cyanotic and non cyanotic congenital heart disease patients. Methods., Fourteen cyanotic and 22 noncyanotic congenital heart disease patients were studied in the Adult Congenital Heart Disease Unit at the Complejo Hospitalario Universitario Insular-Materno Infantil. Demographic characteristics, complete blood count, and 24-hour urianalysis were obtained, including abdominal ultrasound in those with cyanosis. Results., No differences were seen between age (years) (27.4 ± 8.2; 26.4 ± 8.3; P = .71), sex, size, weight, or glomerular filtration rate (mL/min/1.73 m2) (81.1 ± 22.9 vs. 84.9 ± 9.2, P = .482) between cyanotic and noncyanotic patients. However, Eisenmenger patients had significantly impaired renal function when compared with noncyanotic patients (73.0 ± 17.3 vs. 84.9 ± 9.2 mL/min/1.73 m2, P = .023). Significant differences were obtained in oxygen saturation (%) (83.8 ± 5.8 vs. 97.8 ± 0.8; P = .000), hematocrit (%) (59.3 ± 8.1 vs. 40.9 ± 8.5; P = .000), platelets (103/µL) (161.5 ± 70.5 vs. 277.9 ± 57.6; P = .000), serum uric acid (mg/dL) (7.5 ± 2.3 vs. 5.6 ± 1.5; P = .008) and microalbuminuria (mg/24 hours) (12.8 [0, 700.2] vs. 2.4 [0, 18.9]; P = .000) between cyanotic and noncyanotic patients. Five cyanotic patients (35.7%) had microalbuminuria (>30 mg/24 hours) and three of them (21.4%) proteinuria (>1 g/24 hours). No significant differences were seen between serum and urine parameters between cyanotic patients who had microalbuminuria (>30 mg/24 hours) and those cyanotic patients who did not have it (<30 mg/24 hours). Conclusions., Renal impairment is frequently seen in congenital heart disease patients, being associated occasionally with proteinuria and microalbuminuria in cyanotic ones. [source] Hormetic effects of gamma radiation on the stress axis of natural populations of meadow voles (Microtus pennsylvanicus)ENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 2 2005Rudy Boonstra Abstract We tested the hypothesis that low doses of gamma radiation have beneficial, hormetic effects on the stress axis (the hypothalamic-pituitary-adrenocortical axis) of free-ranging meadow vole populations (Microtus pennsylvanicus). Voles were exposed to chronic gamma radiation from a 137Cs field irradiator. In isolated populations, voles received one of three treatments over a four-year period: Controls (0.19,0.42 ,Gy/h , levels that were 2,5X above background levels [0.1 ,Gy/h] and live-trapped in all years , 1982,1985), low doses (22.6 ,Gy/h , 50,200X background, live-trapped from November 1982,April 1985), or high doses (3,840 ,Gy/h , 40,000X background, live-trapped from November 1983,April 1985). Voles exposed to a low dose had levels of free and total corticosterone that were significantly higher than those in the control or high-dose groups. Differences in response to radiation between the sexes were apparent for maximum corticosterone-binding capacity, with females exposed to low doses having higher binding capacity than control or high-dose females, whereas males exposed to low doses had lower binding capacity than control or high-dose males. Low-dose voles had higher counts of neutrophils than either the controls or high-dose voles; hematocrit was greater in the controls than in irradiated voles. These results indicate that voles display a hormetic response to radiation, wherein low doses of an otherwise harmful agent produce a beneficial effect. The stimulation of the stress axis resulting in the increased secretion of glucocorticoids, which may protect against the excessive actions of the immune and inflammatory responses, may be a key mechanism producing this effect. [source] Effects of sublethal concentrations of atrazine and nitrate on metamorphosis of the African clawed frogENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 3 2003Karen Brown Sullivan Abstract Tadpoles of the African clawed frog (Xenopus laevis) were exposed to sublethal concentrations of atrazine (0, 40, and 320 ,g/L) and nitrate (0, 37, and 292 mg/L) from feeding stage to metamorphosis. A 3 × 3 factorial design was used to identify both single and interactive effects. At metamorphosis, tadpole weight, snout,vent length (SVL), and hematocrit were determined. Mean mortality was greater in tanks receiving 320 ,g/L atrazine; nitrate had no effect on mortality. Significant differences for all mean traits at metamorphosis occurred among atrazine treatments; higher atrazine exposure increased time to metamorphosis and decreased weight, SVL, and hematocrit. Nitrate treatments were not significantly different. Significant interaction tests between atrazine and nitrate occurred for weight and SVL at metamorphosis; the specific type of interaction varied among treatments. Assuming an additive mixture model, at low atrazine (40 ,g/L), the addition of 37 mg/L nitrate produced SVL values less than expected (a synergistic effect) while the addition of 292 mg/L nitrate yielded SVL values greater than expected (an antagonistic effect). A similar response was noted for tadpoles in the 320-,g/L atrazine treatments. These results indicate that environmentally realistic concentrations of atrazine exert a negative impact on amphibian metamorphosis. Also, this study suggests that mixtures of agricultural chemicals, even if sublethal, may exert negative and not necessarily consistent mixture effects. [source] Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in ,large' preterm infantsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2007Vassiliki Schiza Abstract Background:, Preterm infants are at risk of developing iron deficiency; among the iron status and hemopoiesis indices the serum transferrin receptor (sTfr) has been shown to be a useful indicator in assessing iron status, while immature reticulocyte production is regarded as an estimator of erythropoiesis. Objective:, To investigate age-related changes in iron status infants born ,moderately' preterm, with a gestational age (GA) of 32,36 wk, and identify associations between sTfr and other hematological and biochemical iron indices. Design:, Hospital-based prospective, longitudinal study in preterm infants. Methods:, Iron and erythropoiesis parameters were evaluated in 181 formula-fed preterm infants at 2 and 6 wk and 3, 6, 9, and 12 months chronological age. Hemoglobulin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), reticulocytes, serum iron (sFe), serum ferritin (sFer), sTfr, and reticulocyte subpopulations were measured. Results:, A total of 756 measurements were performed. After an initial decline, Hb rose from month 3 to 12 of life. SFe and sFer and immature reticulocyte count decreased from the second week to the third month and remained stable thereafter. STfr was lower up to 6 wk and stable from month 3 to 12. Iron deficiency anemia (IDA) was found in 5.5% of infants. In 76 measurements sFer was <12 ,g/L, implying storage iron deficiency (SID). A negative correlation was observed between sTfr and other indices of iron status such as Hb, Hct, MCV, sFe, and sFer. Infants with sFer <12 ,g/L had lower sTfr than those with sFer >12 ,g/L. Reticulocyte production was positively associated with STfr, but this association was dependent on the chronological age of the infant. Conclusion:, Iron depletion is common in formula-fed preterm (32,36 wk GA) infants between month 3 and 12 of life. STfr appears to be an indicator of iron status in preterm infants during the first year of life. [source] Bioreactance: A new tool for cardiac output and thoracic fluid content monitoring during hemodialysisHEMODIALYSIS INTERNATIONAL, Issue 4 2009Niloufar KOSSARI Abstract Outpatient hemodialysis therapy (HD) can be associated with hemodynamic compromise. Bioreactance® has recently been shown to provide accurate, noninvasive, continuous, measurements of cardiac output (CO) and thoracic impedance (Zo) from which thoracic fluid content (TFC) can be derived assuming TFC=1000/Zo. This study was designed to evaluate the changes in TFC in comparison with the traditional indices of fluid removal (FR) and to understand the trends in CO changes in HD patients. Minute-by-minute changes in TFC and CO were prospectively collected using the bioreactance system (NICOM®) in HD patients of a single unit. Changes in body weight (,W), hematocrit (,Hct), and amount of FR were also measured. Twenty-five patients (age 77 ± 11 years) were included. The TFC decreased in all patients by an average of 5.4 ± 7.9 k,,1, weight decreased by 1.48 ± 0.98 kg, and FR averaged 2.07 ± 1.93 L over a 3- to 4-hour HD session. There were good correlations between ,TFC and ,W (R=0.80, P<0.0001) and FR (R=0.85, P<0.0001). ,Hct (4.13 ± 3.42%) was poorly correlated with ,TFC (R=0.35, P=0.12) and FR (R=0.40, P=0.07). The regression line between FR and TFC yielded FR=1.0024,0.1985TFC; thus, a 1 k,,1 change of Zo correlates with an ,200 mL change in total body water. The change in CO (,0.52 ± 0.49 L/min m2) during HD did not correlate with FR (R=0.15, P=NS). Changes in TFC represented the monitored variable most closely related to FR. CO remained fairly constant in this stable patient cohort. Further studies in high-risk patients are warranted to understand whether TFC and CO monitoring can improve HD session management. [source] Correction of an anemia in patients with a terminal stage chronic renal insufficiency on haemodialysisHEMODIALYSIS INTERNATIONAL, Issue 1 2005R.Z. Ismagilov One of the basic symptoms of a terminal stage chronic renal insufficiency is anemia. From everything, used methods of correction of an anemia, it is considered the most effective application of preparations recombinant human erythropoietin (r-Hu EPO). Since 1994 in the Scientific Centre of Surgery begins application r-Hu EPO. Application r-Hu EPO in patients with a terminal stage chronic renal insufficiency in 90,95% of cases had a positive effect, but 5,10% of patients have intolerance to erythropoietin, that has induced to search of new effective methods of correction of anemia. During research were determined quantity erythrocytes, hemoglobin, reticulocyte in peripheral blood and acid-alkaline condition of blood. All hematology parameters were defined at the beginning of treatment, over 5 day and for 15 day of stimulation of a bone marrow. For 15 days after stimulation of a bone marrow by the laser there was an authentic increase of quantity erythrocyte, hemoglobin, hematocrit. The initial contents erythrocytes made 2.22 ± 0.1 10 × 12, hemoglobin 67.7 ± 3.2 g/l and hematocrit 18.2 ± 1.2%. During treatment by the laser parameters erythrocytes have increased up to 2.9 ± 0.8 10 × 12, hemoglobin up to 89.6 ± 2.9 g/l and hematocrit up to 28.2 ± 1.3%(P < 0,005). Hematology parameters in blood of control group authentically have not changed. [source] Uncommon skin lesion in a patient with ataxia-telangiectasiaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2008Chinedu Ivonye MD A 20-year-old African-American man, with a history of ataxia-telangiectasia diagnosed at the age of one year, presented to the hospital with fever, cough, and headache of 2 days' duration. The fever was of high grade, associated with chills and rigors. The headache was frontal in location, constant, pounding in nature, and associated with photophobia and phonophobia; there was no neck pain, no neck stiffness, and no blurring of vision. The patient complained of facial pain. There were no relieving or aggravating factors. The family denied any change in mental status. ,The cough was productive of yellowish sputum. There was associated rhinorrhea. The patient complained of nausea and vomiting with the headache. A review of other systems was negative. ,On presentation in the emergency room, the patient was tachypneic, febrile, and tachycardic. He was oriented to time, place, and person. His neck was supple and meningeal signs were negative. He had maxillary sinus tenderness. Neurologic examination revealed nystagmus, ocular telangiectasia (Fig. 1), ataxia, and globally decreased muscle strength. Skin examination showed hypopigmented areas on all four extremities, the face, and neck (Figs 1,4), without involvement of the trunk. The rest of the physical examination was unremarkable. Figure 1. Area of vitiligo on the neck with premature graying of the hair Figure 2. Vitiligo on the hands Figure 3. Vitiligo involving the legs Figure 4. Ocular telangiectasia ,The leukocyte count was elevated at 19,600/mcL, with a differential of neutrophils (84%), monocytes (11%), and lymphocytes (5%). Hemoglobin and hematocrit were normal. Chemistry and chest X-ray were normal. ,Computed tomography scan of the head showed acute sinusitis and cerebellar atrophy consistent with ataxia-telangiectasia. ,A lumbar puncture was performed, and cerebrospinal fluid findings were suggestive of aseptic meningitis. ,The patient was treated for aseptic meningitis and acute sinusitis with acyclovir and ceftriaxone. The leukocyte count normalized, the patient remained afebrile, and was asymptomatic after 2 days of treatment with antimicrobials. The rest of the hospital stay was uneventful. [source] A child with spider bite and glomerulonephritis: a diagnostic challengeINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2000Jennifer M. Lung MD A previously healthy 7-year-old white boy presented to St. Louis Children's Hospital with a 1-day history of headache, malaise, temperature of 38.7 °C, and a progressively erythematous, tender calf with central dusky purpura. On the morning of admission, his mother noticed a 2-mm crust on the patient's right calf with a 3-cm × 3-cm area of surrounding erythema. No history of recent trauma or bite was obtained. He had suffered two episodes of nonbloody, nonbilious emesis during the last day. In addition, over the previous 12 h, he presented brown urine without dysuria. His mother and brother had suffered from gastroenteritis over the previous week without bloody diarrhea. On initial physical examination, there was a 6-cm × 11-cm macular tender purpuric plaque with a central punctum on the right inner calf, which was warm and tender to the touch, with erythematous streaking towards the popliteal fossa ( Fig. 1). The inguinal area was also erythematous with tender lymphadenopathy and induration, but without fluctuance. Laboratory studies included an elevated white blood cell count of 20,800/,L with 6% bands, 86% segs, and 7% lymphocytes, hemoglobin of 12.5 g/dL, hematocrit of 35.1%, and platelets of 282,000/,L. The prothrombin time/activated partial tissue thromboplastin was 10.4/28.0 s (normal PT, 9.3,12.3 s; normal PTT, 21.3,33.7 s) and fibrinogen was 558 mg/dL (normal, 192,379 mg/dL). Urinalysis showed 1+ protein, 8,10 white blood cells, too numerous to count red blood cells, and no hemoglobinuria. His electrolytes, blood urea nitrogen (BUN), and creatine were normal. The urine culture was negative. Blood culture after 24 h showed one out of two bottles of coagulase negative Staphylococcus epidermidis. Figure 1. (A) 7-year-old boy with painful purpura of the calf The patient's physical examination was highly suggestive of a brown recluse spider bite with surrounding purpura. Over the next 2 days, the surrounding rim of erythema expanded. The skin within the plaque cleared and peeled at the periphery. The coagulase negative staphylococci in the blood culture were considered to be a contaminant. Cefotaxime and oxacillin were given intravenously. His leg was elevated and cooled with ice packs. The patient's fever resolved within 24 h. The lesion became less erythematous and nontender with decreased warmth and lymphadenopathy. The child was discharged on Duricef for 10 days. Because the patient experienced hematuria rather than hemoglobinuria, nephritis was suggested. In this case, poststreptococcal glomerulonephritis was the most likely cause. His anti-streptolysin-O titer was elevated at 400 U (normal, <200 U) and C3 was 21.4 mg/dL (normal, 83,177 mg/dL). His urine lightened to yellow,brown in color. His blood pressure was normal. Renal ultrasound showed severe left hydronephrosis with cortical atrophy, probably secondary to chronic/congenital ureteropelvic junction obstruction. His right kidney was normal. [source] Hematological parameters and anaerobic threshold in Brazilian soccer players throughout a training programINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 2 2008A. S. R. SILVA Summary We assessed the responses of hematological parameters and their relationship to the anaerobic threshold of Brazilian soccer players during a training program. Twelve athletes were evaluated at the beginning (week 0, T1), in the middle (week 6, T2), and at the end (week 12, T3) of the soccer training program. On the first day at 7:30 am, before collecting the blood sample at rest for the determination of the hematological parameters, the athletes were conducted to the anthropometric evaluation. On the second day at 8:30 am, the athletes had their anaerobic threshold measured. Analysis of variance with Newman,Keuls'post hoc was used for statistical comparisons between the parameters measured during the soccer training program. Correlations between the parameters analyzed were determined using the Pearson's correlation coefficient. Erythrocytes concentration, hemoglobin, and hematocrit were significantly increased from T1 to T2. The specific soccer training program led to a rise in erythrocytes, hemoglobin, and hematocrit from T1 to T2. We assumed that these results occurred due to the plasma volume reduction and may be explained by the soccer training program characteristics. Furthermore, we did not observe any correlation between the anaerobic threshold and the hematological parameters. [source] Venous stasis and routine hematologic testingINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 5 2006G. LIPPI Summary Prolonged venous stasis, as generated by a long tourniquet placement, produces spurious variations in several measurable analytes. To verify to what extent venous stasis influences routine hematologic testing, we assessed routine hematologic parameters, including hemoglobin, hematocrit, red blood cell count (RBC), main cell hemoglobin (MHC), main cell volume (MCV), platelet count (PLT), main platelet volume (MPV), white blood cell count (WBC) and WBC differential on the Advia 120 automated hematology analyzer in 30 healthy volunteers, either without venous stasis (no stasis) or after application of a 60 mmHg standardized external pressure by a sphygmomanometer, for 1 (1-min stasis) and 3 min (3-min stasis). Although the overall correlation between measures was globally acceptable, the mean values for paired samples were significantly different in all parameters tested, except MCV, MHC, PLT, MPV, eosinophils, basophils and large unstained cells after 1-min stasis and all parameters except MCV, MHC, MPV and basophils after 3-min venous stasis. As expected RBC, hemoglobin and hematocrit displayed a significant trend towards increase, whereas WBC and the WBC subpopulations were decreased. Difference between measurements by Bland and Altman plots exceeded the current analytical quality specifications for desirable bias for WBC, RBC, hemoglobin, hematocrit, lymphocytes and monocytes in samples collected after either 1- and 3-min stasis. These results provide clear evidence that venous stasis during venipuncture might produce spurious and clinically meaningful biases in the measurement of several hematologic parameters, prompting further considerations on the usefulness of adopting appropriate preventive measures for minimizing such influences. [source] Significant differences between capillary and venous complete blood counts in the neonatal periodINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 1 2003S.M. Kayiran Summary The normal capillary and venous hematologic values for neonates have not been defined clearly. It is well known that capillary blood has higher hemoglobin (Hb) and hematocrit (Hct) values than venous blood. In a recent study, we reported differences between capillary and venous complete blood counts (CBC) in healthy term neonates on day 1 of life. The aim of this study was to extend our previous investigation. Term neonates (n=141) were stratified into four groups by days of postnatal age: group 2 (day 7, n=38), group 3 (day 14, n=35), group 4 (day 21, n=32) and, group 5 (day 28, n=36). Data from our previous study were included in the statistical analysis as group 1 (day 1, n=95). A CBC and differential count were carried out on each capillary and venous sample drawn simultaneously. Within each group, the mean and standard deviation for each parameter in capillary and venous blood were calculated and then compared using the paired sample t -test. In all groups, the capillary blood samples had higher Hb, Hct, red blood cell (RBC), white blood cell (WBC), and lymphocyte counts. In each group, venous platelet counts were significantly higher than the corresponding capillary values. There was also a trend toward higher venous mean corpuscular volume, higher capillary polymorphonuclear leukocyte (PML) count and mean platelet volume in all groups. In both capillary and venous blood, Hb, Hct, RBC, MCV values and WBC, lymphocyte, PML counts decreased and platelet counts increased steadily during neonatal period. This study reveals that CBC parameters and differential counts may differ depending on the blood sampling used. The findings underline the importance of considering the sample source when using hematologic reference ranges for healthy or septic neonates. When interpreting results, the term ,peripheral blood' should be replaced with ,capillary blood' or ,venous blood' so that an accurate assessment can be made. [source] Testosterone Supplementation Therapy for Older Men: Potential Benefits and RisksJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2003David A. Gruenewald MD Serum testosterone levels decline gradually and progressively with aging in men. Many manifestations associated with aging in men, including muscle atrophy and weakness, osteoporosis, reduced sexual functioning, and increased fat mass, are similar to changes associated with testosterone deficiency in young men. These similarities suggest that testosterone supplementation may prevent or reverse the effects of aging. A MEDLINE search was performed to identify studies of testosterone supplementation therapy in older men. A structured, qualitative review was performed of placebo-controlled trials that included men aged 60 and older and evaluated one or more physical, cognitive, affective, functional, or quality-of-life outcomes. Studies focusing on patients with severe systemic diseases and hormone deficiencies related to specific diseases were excluded. In healthy older men with low-normal to mildly decreased testosterone levels, testosterone supplementation increased lean body mass and decreased fat mass. Upper and lower body strength, functional performance, sexual functioning, and mood were improved or unchanged with testosterone replacement. Variable effects on cognitive function were reported, with improvements in some cognitive domains (e.g., spatial, working, and verbal memory). Testosterone supplementation improved exercise-induced coronary ischemia in men with coronary heart disease, whereas angina pectoris was improved or unchanged. In a few studies, men with low testosterone levels were more likely to experience improvements in lumbar bone mineral density, self-perceived functional status, libido, erectile function, and exercise-induced coronary ischemia with testosterone replacement than men with less marked testosterone deficiency. No major unfavorable effects on lipids were reported, but hematocrit and prostate specific antigen levels often increased. Based on these results, testosterone supplementation cannot be recommended at this time for older men with normal or low-normal testosterone levels and no clinical manifestations of hypogonadism. However, testosterone replacement may be warranted in older men with markedly decreased testosterone levels, regardless of symptoms, and in men with mildly decreased testosterone levels and symptoms or signs suggesting hypogonadism. The long-term safety and efficacy of testosterone supplementation remain uncertain. Establishment of evidence-based indications will depend on further demonstrations of favorable clinical outcomes and symptomatic, functional, and quality-of-life benefits in carefully performed, long-term, randomized, placebo-controlled clinical trials. J Am Geriatr Soc 51:101,115, 2003. [source] Diphenyl diselenide protects against hematological and immunological alterations induced by mercury in miceJOURNAL OF BIOCHEMICAL AND MOLECULAR TOXICOLOGY, Issue 5 2008Ricardo Brandão Abstract Mercury is a heavy metal that can cause a variety of toxic effects on the organism, such as hematological and immunological alterations. In the present investigation, deleterious effects of mercury-intoxication in mice and a possible protective effect of diphenyl diselenide (PhSe)2 were studied. Male adult Swiss albino mice received daily a pretreatment with (PhSe)2 (15.6 mg/kg, orally) for 1 week. After this week, mice received daily mercuric chloride (1 mg/kg, subcutaneously) for 2 weeks. A number of hematological (erythrocytes, leukocytes, platelets, hemoglobin, hematocrit, reticulocytes, and leukocytes differential) and immunological (immunoglobulin G and M plasma concentration) parameters were evaluated. Another biomarker of tissue damage, lactate dehydrogenase (LDH), was also determined. The results demonstrated that mercury exposure caused a reduction in the erythrocyte, hematocrit, hemoglobin, leukocyte, and platelet counts and an increase in the reticulocyte percentages. (PhSe)2 was effective in protecting against the reduction in hematocrit, hemoglobin, and leukocyte levels. (PhSe)2 ameliorated reticulocyte percentages increased by mercury. However, (PhSe)2 was partially effective in preventing against the decrease in erythrocyte and platelet counts. Immunoglobulin G and M concentrations and LDH activity were increased by mercury exposure, and (PhSe)2 was effective in protecting against these effects. In conclusion, (PhSe)2 was effective in protecting against hematological and immunological alterations induced by mercury in mice. © 2008 Wiley Periodicals, Inc. J Biochem Mol Toxicol 22:311,319, 2008; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/jbt.20242 [source] Anticoagulation After Coronary Artery Surgery in Patients With Polycythemia Vera: Report of Two CasesJOURNAL OF CARDIAC SURGERY, Issue 5 2007Bilgehan Sava, Oz M.D. Normalization of the hematocrit and elevated platelet counts is obligatory to reduce the thrombotic risk of patients with PV. Therapeutic strategies include phlebotomy, myelosuppressive agents, and, more recently, interferon-,. In addition, appropriate antiplatelet therapy should be administered to prevent life-threatening complications and reducing the viscosity of the blood. Although aspirin is widely preferred in such patients, this monodrug therapy or combined with clopidogrel as an alternative approach might not be enough, especially after coronary artery surgery. Therefore, warfarin should be added to anticoagulant therapy. This short report describes the use of warfarin, associated with aspirin and clopidogrel as an anticoagulant regimen after coronary artery bypass surgery in two cases with polycythemia vera. We believe that a combination of warfarin with other oral antiplatelet agents may be more effective in preventing the coronary artery bypass graft thrombosis. [source] Red cell exchange transfusion for babesiosis in Rhode IslandJOURNAL OF CLINICAL APHERESIS, Issue 3 2009Joshua Spaete Abstract We report four cases of clinically severe tick borne babesiosis treated with chemotherapy and adjunctive red cell exchange (RCE) at two Rhode Island hospitals from 2004 to 2007. All RCE procedures were performed using a Cobe Spectra device and were well tolerated without complications. The volume of allogeneic red cells used in the exchange was determined using the algorithm in the apheresis device with the input variables of preprocedure hematocrit, weight, height, an assumed allogeneic red cell hematocrit of 55 and a desired post procedure hematocrit of 27. The preprocedure level of parasitemia varied between 2.4% and 24% and the postprocedure level of parasitemia between 0.4 and 5.5% with an average overall percent reduction in parasitemia of 74%. Retrospectively, application of a new formula to calculate red cell mass appeared to correlate better with the percent reduction in parasitemia. Previous reports of RCE in babesiosis were reviewed. The reported reduction in parasitemia varied from 50% to >90%. Although a preprocedure level of parasitemia of 10% is sometimes used as a threshold for RCE in clinically severe babesiosis, this threshold does not have a firm empirical basis. No postprocedure desired level of parasitemia is indicated nor the mass of allogeneic red cells needed to achieve such a level. We conclude that current estimates of the dose of allogeneic red cells used in RCE are probably inaccurate, advocate a new formula to estimate this dose and suggest that a 90% reduction in parasitemia should be the minimally desired target of RCE in babesiosis. J. Clin. Apheresis, 2009. © 2009 Wiley-Liss, Inc. [source] Comparison of plateletpheresis on the Fresenius AS.TEC 204 and Haemonetics MCS 3pJOURNAL OF CLINICAL APHERESIS, Issue 1 2007Sudha Ranganathan Abstract This is an attempt at comparing two cell separators for plateletpheresis, namely the Fresenius AS.TEC 204 and Haemonetics MCS 3p, at a tertiary care center in India. Donors who weighed between 55,75 kg, who had a hematocrit of 41,43%, and platelet counts of 250 × 103,400 × 103/,l were selected for the study. The comparability of the donors who donated on the two cell separators were analysed by t -test independent samples and no significant differences were found (P > 0.05). The features compared were time taken for the procedure, volume processed on the separators, adverse reactions of the donors, quality control of the product, separation efficiency of the separators, platelet loss in the donors after the procedure, and the predictor versus the actual yield of platelets given by the cell separator. The volume processed to get a target yield of >3 × 1011 was equal to 2.8,3.2 l and equal in both the cell separators. Symptoms of citrate toxicity were seen in 4 and 2.5% of donors who donated on the MCS 3p and the AS.TEC 204, respectively, and 3 and 1% of donors, respectively, had vasovagal reactions. All the platelet products collected had a platelet count of >3 × 1011; 90% of the platelet products collected on the AS.TEC 204 attained the predicted yield that was set on the cell separator where as 75% of the platelet products collected on the MCS 3p attained the target yield. Quality control of the platelets collected on both the cell separators complied with the standards except that 3% of the platelets collected on the MCS 3p had a visible red cell contamination. The separation efficiency of the MCS 3p was higher, 50,52% as compared to the 40,45% on the AS.TEC 204. A provision of double venous access, less adverse reactions, negligible RBC contamination with a better predictor yield of platelets makes the AS.TEC 204 a safer and more reliable alternative than the widely used Haemonetics MCS 3p. J. Clin. Apheresis. © 2006 Wiley-Liss, Inc. [source] Comparison of CD34+ cell collection efficiency on the COBE Spectra and Fenwal CS-3000 plusJOURNAL OF CLINICAL APHERESIS, Issue 1 2002C.D. Ford Abstract Optimal collections of mobilized CD34+ cells are important in terms of both patient toxicity and cost. The factors that determine CD34+ collection efficiency (CD34eff) of cell separators have not been well studied. In addition, because several cell separators are available, the type of collection device may also be a significant variable. Previous studies comparing the Baxter-Fenwal CS3000 and the COBE Spectra have not yielded consistent conclusions. Therefore, we retrospectively analyzed the collection outcomes of 163 consecutive donors with a peripheral CD34+ cell concentration (pCD34) of ,5 cells/,l on the first collection that had been harvested on one or the other device. The CS3000 was found to yield a significantly higher CD34eff (50% vs. 39%, P = 0.006). However, donors were not balanced for several prognostic factors, which may contribute to CD34eff including mobilization with G-CSF vs. chemotherapy+G-CSF, average flow rate, and total volume of peripheral blood processed. When appropriate variables were included in a stepwise multiple variable analysis, cell separator type emerged as a significant independent predictive factor for CD34eff (P = 0.018). Our data indicates that the CS3000 will, on average, show a higher absolute CDeff of 8%. Furthermore, since the two devices differ in mechanism, prognostic factors may also differ. Comparisons suggest that peripheral blood WBC and hematocrit may be more important predictors for the CS3000. J. Clin. Apheresis 17:17,20, 2002. © 2002 Wiley-Liss, Inc. [source] Effects of altitude on spleen volume: Sonographic assessmentJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2007Guner Sonmez MD Abstract Purpose. To use sonography to determine changes that may arise in splenic volume in humans from regions of lower altitude who begin to live in regions of higher altitude. Materials and Methods. The study was conducted in the Turkish province of A,r,, at an altitude of 1750 m and included 108 healthy, nonsmoking, disease-free volunteers who had moved from regions at an altitude lower than 500 m. Length, width, and thickness of the spleen were measured using sonography. Splenic volume was calculated using the following standard ellipsoid formula: length × width × thickness × 0.523. Sonographic assessments were repeated at 3 and 6 months along with other blood tests, including hemoglobin, hematocrit, and platelet levels. Results. The mean ± SD splenic volume was 299 ± 97 cm3 (range, 116,574 cm3). At 3 and 6 months, the splenic volumes decreased significantly compared to their initial values (p < 0.05). An increase in hemoglobin, hematocrit, and platelet count was observed in all subjects. Conclusion. Our data show that splenic volume in healthy individuals who begins to live at high altitudes decreases gradually. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source] Vasopressin decreases intestinal mucosal perfusion: a clinical study on cardiac surgery patients in vasodilatory shockACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2009A. NYGREN Background: Low to moderate doses of vasopressin have been used in the treatment of cathecholamine-dependent vasodilatory shock in sepsis or after cardiac surgery. We evaluated the effects of vasopressin on jejunal mucosal perfusion, gastric-arterial pCO2 gradient and the global splanchnic oxygen demand/supply relationship in patients with vasodilatory shock after cardiac surgery. Methods: Eight mechanically ventilated patients, dependent on norepinephrine to maintain mean arterial pressure (MAP) ,60 mmHg because of septic/post-cardiotomy vasodilatory shock and multiple organ failure after cardiac surgery, were included. Vasopressin was sequentially infused at 1.2, 2.4 and 4.8 U/h for 30-min periods. Norepinephrine was simultaneously decreased to maintain MAP at 75 mmHg. At each infusion rate of vasopressin, data on systemic hemodynamics, jejunal mucosal perfusion, jejunal mucosal hematocrit and red blood cell velocity (laser Doppler flowmetry) as well as gastric-arterial pCO2 gradient (gastric tonometry) and splanchnic oxygen and lactate extraction (hepatic vein catheter) were obtained. Results: The cardiac index, stroke volume index and systemic oxygen delivery decreased and systemic vascular resistance and systemic oxygen extraction increased significantly, while the heart rate or global oxygen consumption did not change with increasing vasopressin dose. Jejunal mucosal perfusion decreased and the arterial-gastric-mucosal pCO2 gradient increased, while splanchnic oxygen or lactate extraction or mixed venous,hepatic venous oxygen saturation gradient were not affected by increasing infusion rates of vasopressin. Conclusions: Infusion of low to moderate doses of vasopressin in patients with norepinephrine-dependent vasodilatory shock after cardiac surgery induces an intestinal and gastric mucosal vasoconstriction. [source] Repeatability of hematocrits and body mass of Gray CatbirdsJOURNAL OF FIELD ORNITHOLOGY, Issue 1 2010Margret I. Hatch ABSTRACT Hematocrits may provide information about the physiological condition of birds, but, to be a useful measure, information is needed concerning how hematocrits vary among individuals and over time. We examined the repeatability of hematocrits in a population of Gray Catbirds (Dumetella carolinensis) in Pennsylvania at several time scales and also examined the repeatability of body mass, another measure commonly used as an indicator of condition. Both hematocrit (r= 0.64) and mass (r= 0.65) were repeatable (P < 0.01) for first captures between years and between first and second captures within a year (r= 0.41 and r= 0.50, respectively; P < 0.01), but not repeatable (P > 0.05) between captures in different months within a year (r= 0.11 for both). Repeatability of both measures differed by sex and age. Females exhibited repeatability of hematocrit and body mass only between years, while male hematocrits were repeatable between years and between first and second captures within a season. Male mass was repeatable for all time periods. Hematocrits of younger birds were repeatable between captures within a season and their body mass was repeatable between months and weeks while hematocrits of older birds were not repeatable and their body mass was repeatable only between captures in a season. Our results indicate that hematocrits and body mass had similar repeatability coefficients overall, but that hematocrits of Gray Catbirds were a consistent trait of individuals only across years. Because repeatability between captures and months depended on sex and age, we conclude that the hematocrit is a useful measure of individual performance only in limited circumstances. RESUMEN El hematocrito podría proveer información sobre la condición física de las aves pero para ser una medida útil se necesita información sobre como el hematocrito varia entre individuos y a través del tiempo. Examinamos la repetibilidad del hematocrito en una población de Dumetella carolinensis en Pennsylvania durante diferentes escalas temporales. También examinamos la repetibilidad del peso corporal, otra medida comúnmente usada como indicador de la condición del individuo. El hematocrito (r= 0.64) y el peso corporal (r= 0.65) eran repetibles (P < 0.01) para las primeras capturas entre años y entre la primera y segunda captura dentro del año (r= 0.41 y r= 0.50, respectivamente; P < 0.01), pero no eran repetibles (P > 0.05) entre capturas realizadas en diferentes meses dentro del año (r= 0.11 para los dos). La repetibilidad de las dos medidas difiere por sexo y edad. Las hembras se caracterizaron por tener repetibilidad del hematocrito y del peso corporal solo entre años, mientras que el hematocrito de los machos era repetible entre años y entre la primera y segunda captura dentro de la temporada. El peso corporal de los machos era repetible durante todos los periodos a través del tiempo. El hematocrito de las aves mas jóvenes era repetible entre capturas dentro de la temporada y su peso corporal era repetible entre meses y semanas, mientras que el hematocrito de las aves mayores no era repetible y su peso corporal era repetible solo entre capturas dentro de la temporada. Nuestros resultados indican que los hematocritos y el peso corporal en general tuvieron coeficientes de repetibilidad similares, pero que los hematocritos de D. carolinensis eran un rasgo consistente de los individuos solo entre años. Por la razón que la repetibilidad entre capturas y meses dependía del sexo y edad, concluimos que el hematocrito es una medida útil del performance individual solo en circunstancias limitadas. [source] Relationships between tail-flicking, morphology, and body condition in MoorhensJOURNAL OF FIELD ORNITHOLOGY, Issue 1 2006Fernando Alvarez ABSTRACT Prey-predator communication of alertness has been reported for Moorhens (Gallinula chloropus) and other species of birds. Because ability to flee is probably related to body condition, healthy potential prey may behave more conspicuously to send predators an unambiguous message. Moorhens have a contrasting rump patch that is flashed by rapid tail-flicking. During two winter months, we observed sex-related differences in the rate of tail-flicking. Females tail-flicked at a faster rate than males, and more vigilant and more symmetrical males tail-flicked faster. The rate of tail-flicking was negatively correlated to the heterophil/lymphocyte ratio in both sexes and positively correlated to hematocrit and albumin/globulin ratio in females. These results suggest that male and female Moorhens in better physical condition tail-flick at a faster rate and support the pursuit deterrent hypothesis, with healthy individuals appearing to inform predators that they would be difficult to capture. SINOPSIS Es conocida la comunicación del estado de alerta de las presas hacia los predadores potenciales en la Gallineta Gallinula chloropus y en otras especies de aves. Puesto que la facilidad de captura está probablemente relacionada con la condición física, sería de esperar que los individuos presa en mejor condición física actuaran de forma más conspicua, pudiendo así informar sin ambigüedad a los predadores. La Gallineta presenta un escudo anal contrastado, que se hace más conspicuo mediante rápidos movimientos verticales de la cola. Durante dos meses invernales se registraron las diferencias en la tasa de movimiento de cola con relación al sexo de los sujetos, así como su relación con la tasa de vigilancia y con varios parámetros de condición física. Las hembras presentaron mayor tasa de exhibición del escudo anal que los machos, y los más vigilantes y más simétricos de éstos realizaron una exhibición más rápida. Mientras que en ambos sexos la tasa de exhibición apareció relacionada negativamente con la razón heterófilos/linfocitos, en las hembras se mostró positivamente relacionada con su hematocrito y con la razón albúmina/globulina. Estos resultados sugieren que los machos y hembras con mejor salud, así como los machos con tarsos más simétricos, realizan una más rápida exhibición, lo que apoya la hipótesis del efecto disuasorio a la persecución, ya que las presas potenciales podrían estar informando a los predadores respecto a la dificultad de su captura. [source] Transatrial Access to the Normal Pericardial Space For Local Cardiac Therapy: Preclinical Safety Testing with Aspirin and Pulmonary Artery HypertensionJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2001TODD C. PULERWITZ M.D. The reliability, rapidity, and safety of nonsurgical, transatrial pericardial access for local cardiac therapy have been demonstrated in healthy animals. Since many patients take aspirin or have increased right-sided pressures, we evaluated the procedure's safety under these conditions. Transatrial pericardial access was performed in anesthetized pigs following aspirin administration (162 mg po, n = 6) or during experimental pulmonary artery hypertension (n = 4 different animals) and required only 3 minutes following guide catheter positioning. Platelet aggregability testing with arachidonic acid confirmed aspirin effectiveness. Mean pericardial fluid hematocrit was 0.1 ± 0.1% after 2 days of aspirin therapy and 1.9 ± 1.1% at sacrifice 24 hours later (NS). Mean pericardial fluid hematocrit was 1.0 ± 0.5% after 45 minutes of pulmonary artery hypertension and 4.3 ± 0.8% at sacrifice 30 minutes later (NS). Histologic analysis in both groups revealed a small thrombus and localized inflammation at the site of puncture. Neither aspirin use nor pulmonary artery hypertension causes significant bleeding into the pericardial space following transatrial access and thus does not preclude this route for local cardiac drug delivery. [source] Prolonged activated partial thromboplastin time in thromboprophylaxis with unfractionated heparin in patients undergoing cesarean sectionJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2010Shigeki Matsubara Abstract Aim:, Hemorrhage is an important complication of heparin-thromboprophylaxis after surgery. We attempted to clarify the incidence rate of prolonged activated partial thromboplastin time (APTT), representative of hemorrhagic tendency, in Japanese women who received thromboprophylaxis with unfractionated subcutaneous heparin administration after cesarean section (CS). We also determined factors which affected postoperative APTT. Methods:, We studied 280 women who were administered thromboprophylaxis with unfractionated subcutaneous heparin 5000 IU two times per day after CS. Postoperative APTT under heparin was measured and the incidence of its prolongation was determined. Preoperative APTT, blood loss during surgery, postoperative hematocrit, postoperative serum total protein level, and postpartum body weight were measured, and their correlation with postoperative APTT was determined. Results:, Preoperative and postoperative APTT values were 28.3 (26.7,30.3) and 33.8 (31.0,37.5) seconds for median (interquartile range), respectively. Overall, 7.1% of patients showed ,45 s postoperative APTT. Two patients (0.7%) showed ,60 s APTT, one of whom suffered subcutaneous hemorrhage around the abdominal incision with complete healing. There were no other hemorrhagic complications. Preoperative APTT positively, and postpartum body weight inversely, correlated with postoperative APTT. The amount of blood loss, postoperative hematocrit, and postoperative serum total protein level did not correlate with postoperative APTT. No discernible deep vein thrombosis or pulmonary embolism occurred. Conclusion:, Although 7.1% of women under heparin-thromboprophylaxis showed a prolonged APTT that was 150% of the preoperative APTT, serious side effects were not observed. Subcutaneous administration of unfractionated heparin, if checking APTT prolongation 1 day after surgery, may be safe method of thromboprophylaxis after CS. [source] Oral misoprostol for the prevention of primary post-partum hemorrhage during third stage of laborJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 6 2007Christopher A. Enakpene Abstract Aim:, To assess the effectiveness of oral misoprostol compared with methylergometrine in the prevention of primary post-partum hemorrhage during the third stage of labor. Methods:, This was a randomized controlled trial of 864 singleton low-risk pregnant women. The outcomes were total blood loss, duration of the third stage of labor and peripartal change in hematocrit. Comparisons were by the ,2 -test and Student t -test. Relative risks were calculated for side-effects profile. A P -value of less than 0.05 was statistically significant. Results:, The biodata of all the participants were similar. The mean blood loss for the misoprostol and methylergometrine groups was 191.6 ± 134.5 mL and 246.0 ± 175.5 mL, respectively (95% CI: ,79.3 to ,39.5 mL). The mean duration of the third stage of labor was 19.6 ± 2.4 min and 9.4 ± 3.3 min in the misoprostol and methylergometrine groups, respectively (95% CI: 9.82,10.58 min). More subjects had blood loss >500 mL, 42 (9.7%) versus 6 (1.4%), and peripartal hematocrit change greater than 10%, 38 (8.8%) versus 5 (1.2%), in the methylergometrine group than in the misoprostol group, respectively. Also, more subjects received additional oxytocic in the methylergometrine group, compared to the misoprostol group (80 [18.5%] versus 33 [7.6%] patients, respectively). Conclusions:, Orally administered misoprostol was more effective in reducing blood loss during the third stage of labor than intramuscular methylergometrine. However, there were more subjects in the misoprostol group in whom duration of the third stage of labor was greater than 15 min and who also had manual placental removal than in the methylergometrine group. [source] | ||||||||||||||||||||||||||||||||||