scholarly journals CHANGES IN THE HEMOSTATIC SYSTEM AGAINST THE BACKGROUND OF VARIOUS TREATMENT REGIMENS IN PATIENTS WITH ATHEROSCLEROSIS OF LOWER EXTREMITIES

2019 ◽  
Vol 6 ◽  
pp. 49-59
Author(s):  
Ivan Tverdovsky ◽  
Ivan Tutrin ◽  
Oleg Tarabrin
Keyword(s):  
Treatment Regimen ◽  
Postoperative Period ◽  
Low Frequency ◽  
Lower Extremities ◽  
The State ◽  
Epidural Administration ◽  
Initial State ◽  
Hemostasis System ◽  
Hemostatic System ◽  
Significant Downward Trend

About 2–3 % of the population and about 35–50 % of people over 65 years suffer from obliterating atherosclerosis of the main arteries of the lower extremities. There are many known factors that potentiate atherosclerosis. Some of them are referred to as leading, such as hyperlipoproteinemia or hypertension, others to concomitant contributing to the defeat of the arteries. According to J.S.A. Fuchs include hypertension, hypercholesterolemia and smoking as major risk factors for atherosclerosis. They are less affected by obesity, diabetes, hypertriglyceridemia, sedentary lifestyle, stress Objective of the study. The purpose of this study is to evaluate the functional status of the vascular – platelet, coagulation and fibrinolysis of the hemostasis system and their disorders using low – frequency piezoelectric thromboelastography (LPTEG) in patients with obliterating atherosclerosis of the lower extremities on the background of treatment. Materials and methods. The initial state of the hemostasis system was evaluated in 90 patients undergoing treatment for obliterating atherosclerosis of the lower extremities in the Odessa Regional Clinical Hospital and MD Odreks. All patients underwent surgery in the amount of femoral-popliteal autologous bypass grafting. Patients in the control (1st) group (45 patients) received analgesia during surgery and in the postoperative period based on epidural administration of bupivacaine, and their treatment regimen included enoxaparin 0.4 ml (40,000 anti-XA ME) 2 times a day subcutaneously into the anterolateral surface of the abdominal wall from the first postoperative day and pentoxifylline IV 200 mg twice a day for 7 days. Patients of the studied (2nd) group (45 patients) received analgesia during surgery and in the postoperative period on the basis of epidural administration of bupivacaine, also rivaroxaban 15 mg 2 times a day oraly on the first postoperative day was included in their treatment regimen. The dynamics of the state of the hemostatic system in both groups of patients with OA was evaluated using LPTEG in the first day before surgery and on the 3rd, 5th and 7th postoperative days. Results and conclusions. Before surgery and the start of treatment in patients with OA, against the background of activation of the vascular - platelet link of hemostasis, significant structural and chronometric hypercoagulation with increased thrombin generation and activation of blood fibrinolytic activity are noted. Against the background of treatment in the 1st group, platelet aggregation tends to normalize and there are significant differences compared with the indicators before treatment in the 1st group, the vascular-platelet and fibrinolytic systems did not reach normal values before 7 days, but showed a significant downward trend the degree of manifestation of their violations. Against the background of treatment of the 2nd group, significant changes were observed towards normalization in all components of the hemostatic system according to the LPTEG technique. The state of the coagulation unit of the hemostasis system in patients with OA on the 7th day of therapy does not significantly differ from the norm, it is possible to note significant shifts towards hypocoagulation within the normal range. The fibrinolytic system on the 7th day of treatment does not statistically differ from normal indicators, it has significant positive dynamics compared to 1 day. The second group revealed a statistically significant normalization of all indicators characterizing the blood coagulation potential of the blood and the aggregation ability of platelets, as well as the indicator that is responsible for changes in the fibrinolytic blood system.

scholarly journals Dynamics of perioperative changes in hemostatic potential according to low-frequency piezoelectric thromboelastography data in open transvesical prostatectomy under epidural analgesia

2020 ◽  
Vol 14 (2) ◽  
pp. 109-113
Author(s):  
Oleg A. Tarabrin ◽  
A. S. Suslov ◽  
D. S. Volodychev
Keyword(s):  
Epidural Anesthesia ◽  
Low Frequency ◽  
Perioperative Period ◽  
State Regulation ◽  
The State ◽  
Dynamic Monitoring ◽  
Anesthetic Technique ◽  
Instrumental Method ◽  
Hemostatic System ◽  
The Moment

Background. The anesthetic technique of choice for urological surgeries is a controversial issue, especially for transvesical prostatectomy for patients with benign prostatic hyperplasia (BPH). Often, epidural anesthesia and analgesia are considered as the methods of choice. However, the effect of an anesthetic support on perioperative changes in hemostatic potential has been poorly studied. Aim. The aim of the study was to demonstrate the dynamics of changes in the system of the aggregate blood state regulation by using an instrumental method, a low-frequency piezoelectric thromboelastography (LFPTEG), in the perioperative period for patients with BPH who will undergo transvesical prostatectomy. Material and methods. The state of the hemostatic system in a group of 71 patients with confirmed BPH who required a transvesical prostatectomy was evaluated by the APC ARP-01M Mednord device at the time of the admission, 30 min after the effect of an epidural anesthesia, an hour after the end of a surgery and a day after a surgery. Results. A perioperative dynamic monitoring of the state of a hemostatic balance showed that a preoperative hypercoagulation, compensated by an increased fibrinolysis, was replaced by a normocoagulation at the moment of a surgery, which was observed in the first hour after the end of a surgery and retained until the end of the first day. Conclusion. Hypercoagulation was found out for patients with BPH before a transvesical prostatectomy that was masked by an activation of the fibrinolytic system. The hemostatic potential assumed values identical to the reference values that should be taken into account prescribing a postoperative thromboprophylaxis against the background of a prolonged epidural blockade. The APC ARP-01M Mednord device allows you to assess all parts of a hemocoagulation at each stage of a perioperative treatment quickly and without high material costs.

scholarly journals Evolution of views and modern concepts of the state of the hemostasis system in liver cirrhosis

2021 ◽  
Vol 26 (1) ◽  
pp. 107-114
Author(s):  
S. A. Aliyev ◽  
E. S. Aliyev
Keyword(s):  
Liver Cirrhosis ◽  
Endothelial Dysfunction ◽  
Inflammatory Mediators ◽  
Vascular Endothelium ◽  
The State ◽  
Modern Literature ◽  
Intravascular Coagulation ◽  
Hemostasis System ◽  
Hemostatic System

Aim. To study the state of individual elements of the hemostasis system in liver cirrhosis according to modern literature.Summary. The review presents an analysis of literature data covering the state of the homeostasis system in liver cirrhosis. The pathophysiological and pathogenetic mechanisms that underlie the disorders that occur in various parts of the hemostatic system in this pathology are described in a polemical style. Literature data concerning a relatively littlestudied aspect of cirrhosis – hypercoagulation are analyzed. From the standpoint of modern concepts and taking into account the peculiarities of hemostasis disorders, the pathogenetic significance of the vascular endothelium and endothelial dysfunction is postulated. As well as the role of inflammatory mediators in the development of coagulopathy and intravascular coagulation syndrome in patients with cirrhosis of the liver.

Evaluation of the results of planned open surgical interventions in primary chronic vein disease in pregnant women

2020 ◽  
pp. 51-56
Author(s):  
V.М. Аntonyuk-Kysil ◽  
◽  
І.Y. Dziubanovskyi ◽  
V.М. Yenikeeva ◽  
S.І. Lichner ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Postoperative Period ◽  
Postpartum Period ◽  
Clinical Manifestations ◽  
Lower Extremities ◽  
Vascular Surgeon ◽  
Surgical Interventions ◽  
Perinatal Center ◽  
Vein Disease

The objective: to evaluate the results of planned open surgical interventions (POSI) in pregnant women with primary symptomatic chronic vein disease (PSCVD). Materials and methods. The study included 457 pregnant women operated on a routine basis with PSCVD. The patients underwent ultrasound duplex angioscanning (USDA) of the veins of the lower extremities, inguinal canals, and iliac veins. The severity of the clinical manifestations of PSCVD was evaluated on a VCSS scale. With the help of the circadian visual-analog scale, the dynamics after the operative pain were studied. The effect of POSI on uterine tone and cardiac function of the fetus was investigated using cardiotocography. When forming the results for POSI, data from USDA, the severity of clinical and cosmetic manifestations of PCVD, the need for active prevention of thrombophlebetic, thromboembolic and hemorrhagic complications, minimization of surgical childbirth were taken into account. The results of treatment were studied in 2 groups of patients. Patients of the first group were treated with conservative therapy, the second group – POSI. Parametric indicators, which were presented as mean and standard error M(SD), were used for statistical data processing of the study, and their reliability was estimated using Student’s t-test. The species was determined to be significant at p<0.05. Results. 495 POSI were performed at 28-38 weeks gestation in an obstetric hospital (perinatal center), by a vascular surgeon from the staff of the center, who was familiarized with the peculiarities of working with this contingent of patients. Surgery was performed under local anesthesia in 346 (75.49%) pregnant women at one extremity, in 111 (24.51%) – at two in one session. According to the results of the study, it was noted that in the first group 33.7% of patients had a positive clinical result due to the reduction of pain syndrome, while 67.5% of patients had an increase and spread of varicose transformation in the area of saphenous and/or non-saphenous veins with spread of pathological venous reflux in the distal direction. 78% of patients had the need to administer prophylactic doses of low molecular weight heparins, both during pregnancy and in postpartum period. Out of 126 pregnant women with pronounced varicose veins of the external genital organs and perineum in 36 (28.6%) deliveries were performed by caesarean section. In 9 (3%) patients there was an acute thrombophlebitis of the subcutaneous veins of the lower extremities, which required 5 pregnant women to undergo urgent surgery when the inflammatory process had spread to the middle and above along the femoral vein of the large subcutaneous vein. Pregnant women of the second group with PSCVD on the basis of obstetric hospital (perinatal center) POSI were performed in the organization, which laid the ideology of the FTS program, strictly individual indications for intervention in the optimal terms of pregnancy, multidisciplinary management of patients, due to this in 93% of operated patients regression of clinical manifestations of the disease was noted, whch contributed to the correct and safe delivery of pregnancy with 100% absence of preterm birth, abnormalities in fetal development, pregnancy course, negative impact on obstetric and somatic condition of the pregnant woman. No hemorrhagic, thrombophlebic, thromboembolic complications were noted. Patients in the postoperative period did not require medical support, as during the period of pregnancy, during delivery and in the postpartum period. There were no indications for surgical delivery. 2.4% of patients experienced complications of post-operative wounds in the form of cheese, which had no effect on pregnancy and was eliminated before delivery. In the postoperative period, if necessary, it was recommended to use elastic compression class garments 1–2. Conclusion. POSI made at PSCVD in optimal terms of pregnancy in a specialized obstetric hospital by a vascular surgeon in strictly individual indications is safe, both for the fetus and the pregnant woman. It is promising to further study the results of POSI in pregnant women with PSCVD to introduce it into the arsenal of treatment of this pathology. Key words: FTS ideology, planned open surgical interventions in pregnant women.

Postoperative Anesthesia Of Elderly And Senile Patients With Total Joint Replacement Of The Lower Extremities

2020 ◽  
Vol 2 (09) ◽  
pp. 75-81
Author(s):  
Gaziev Z.T. ◽  
Avakov V.E. ◽  
Shorustamov M.T. ◽  
Bektemirova N.T.
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Period ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Lower Extremities ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Physical Status ◽  
Traumatic Injuries

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

scholarly journals Low frequency of LRV1 in Leishmania braziliensis strains isolated from typical and atypical lesions in the State of Minas Gerais, Brazil

2016 ◽  
Vol 210 (1-2) ◽  
pp. 50-54 ◽  
Author(s):  
Diego H. Macedo ◽  
Armando Menezes-Neto ◽  
Jeronimo M. Rugani ◽  
Ana C. Rocha ◽  
Soraia O. Silva ◽  
...  
Keyword(s):  
Low Frequency ◽  
Minas Gerais ◽  
The State ◽  
Leishmania Braziliensis

scholarly journals In Silico Hemostasis Modeling and Prediction

2020 ◽  
Vol 40 (04) ◽  
pp. 524-535
Author(s):  
Dmitry Y. Nechipurenko ◽  
Aleksey M. Shibeko ◽  
Anastasia N. Sveshnikova ◽  
Mikhail A. Panteleev
Keyword(s):  
In Silico ◽  
Physiological Response ◽  
Platelet Adhesion ◽  
State Of The Art ◽  
Thrombus Formation ◽  
The State ◽  
Modeling And Prediction ◽  
Hemostatic System ◽  
Single Enzyme

AbstractComputational physiology, i.e., reproduction of physiological (and, by extension, pathophysiological) processes in silico, could be considered one of the major goals in computational biology. One might use computers to simulate molecular interactions, enzyme kinetics, gene expression, or whole networks of biochemical reactions, but it is (patho)physiological meaning that is usually the meaningful goal of the research even when a single enzyme is its subject. Although exponential rise in the use of computational and mathematical models in the field of hemostasis and thrombosis began in the 1980s (first for blood coagulation, then for platelet adhesion, and finally for platelet signal transduction), the majority of their successful applications are still focused on simulating the elements of the hemostatic system rather than the total (patho)physiological response in situ. Here we discuss the state of the art, the state of the progress toward the efficient “virtual thrombus formation,” and what one can already get from the existing models.

Clinical and laboratory changes in the hemostasis system in patients with optic nerve vasculitis

2021 ◽  
pp. 23-27
Author(s):  
T.V. Shelkovnikova ◽  
◽  
H.P. Takhchidi ◽  
G.V. Nikolaeva ◽  
G.V. Vavin ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Research Methods ◽  
Lupus Anticoagulant ◽  
Young Patients ◽  
Venous Stasis ◽  
Hemostasis System ◽  
Hemostatic System ◽  
Retinal Microvasculature ◽  
Confirmatory Tests ◽  
Laboratory Changes

Purpose. Clinical and laboratory studies of the hemostasis system in patients with optic nerve vasculitis. Materials and methods. Medical records and case history of 45 people (49 eyes) were analyzed, of which pathology in two eyes was detected in 4 people (8 eyes). The study involved 24 men and 21 women aged 17 to 35 years. The follow-up period ranged from 3 months to 5 years. Standard ophthalmic research methods and special research methods were used. Laboratory methods for the study of hemostasis included the detection of lupus anticoagulant was carried out using poison tests, as well as confirmatory tests with donor plasma and corrective phospholipids. Results. Retinopathy of the type of venous stasis was found in 30 people, neuropathy of the type of stagnant disc – in 15 people. In young patients after a viral infection with damage to the optic nerve in clinical form, retinopathy such as venous stasis and congestive optic nerve head with lupus anticoagulant was found in 73.4% of cases. In patients with vasculitis of the optic nerve with lupus anticoagulant, disturbances in the vascular-platelet and plasma-coagulation links in the hemostatic system were revealed. Conclusion. Lupus anticoagulant significantly reduces thromboresistance of the endothelium of the retinal microvasculature and enhances hypercoagulation, breaks the natural regulation of the hemostasis system and aggravates ischemia of the retina, optic nerve, participates in the pathogenesis of clinical forms of optic nerve vasculitis. Key words: hemostatic system, lupus anticoagulant, thrombophilia, optic nerve vasculitis.

The effect of removing dental plaque with low-frequency ultrasound and ozonized contact medium on the microbiota of the gingival sulcus with diagnosis chronic catarrhal gingivitis of young age patients

2021 ◽  
pp. 98-101
Author(s):  
G. R. Mhoyan ◽  
S. N. Razumova ◽  
A. G. Volkov ◽  
N. Zh. Dikopova ◽  
A. G. Ponomareva ◽  
...  
Keyword(s):  
Young People ◽  
Dental Plaque ◽  
Low Frequency ◽  
The State ◽  
Young Age ◽  
Transient Species ◽  
Resident Species ◽  
Low Frequency Ultrasound ◽  
Frequency Ultrasound ◽  
Ozonated Water

As a result of the study, it was found that the removal of dental plaque using low-frequency ultrasound and ozonized contact medium in chronic generalized catarrhal gingivitis of young people can significantly improve the state of microbiocenosis of the gingival sulcus. The preservation of the main resident species is noted, occasional transient species disappear and the frequency of isolation of aggressive representatives of beta-hemolytic streptococci and periodontopathogenic species decreases. When using ozonated water for the removal of dental deposits, the efficiency of eradication of the microbiota of the gingival sulcus, especially of representatives of aggressive species, is higher than when removing dental deposits without the use of ozonated water.

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