Disseminated intravascular coagulation in a patient with metastatic prostate cancer: Fatal outcome following strontium-89 therapy

Energy Technology Data Exchange (ETDEWEB)

Leong, C.; McKenzie, R.; Coupland, D.B. [Univ. of British Columbia, (Canada)] [and others

1994-10-01

A patient with metastatic prostate cancer was found to have low-grade disseminated intravascular coagulation (DIC). He had significant bone pain despite external-beam radiotherapy and was given {sup 89}Sr with subsequent thrombocytopenia and epistaxis. The patient died from generalized hemorrhage 36 days postinjection. Although it is not possible to establish a causal relationship between {sup 89}Sr and DIC, practitioners should be alert to complications associated with the primary disorder which might occur at a time to raise concern about the intervention. 8 refs., 1 tab.

Intraventricular haemorrhage in preterm infants--can we improve outcome by addressing coagulation?

Science.gov (United States)

Kuperman, Amir A; Brenner, Benjamin; Kenet, Gili

2015-11-01

During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, with the increasing number of very young and extremely low birth weight infants, morbidity is still a major problem. Intraventricular Haemorrhage (IVH) is a major complication of preterm birth, and large haemorrhages or haemorrhages associated with parenchymal brain lesions may yield a high rate of future disability. IVH is a complex, multi-factorial disorder. Prematurity and low birth weight remain as its most important risk factors, affecting vulnerability of the germinal matrix as well as the coagulation system. Approximately 80% of IVHs occur by 72 h after birth, but a considerable proportion of IVH is already visible on the first cranial ultrasound scan within a few hours of birth. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor to IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. The outcome of these studies will be reviewed.

Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

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An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung [Dept. of Radiology, Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

2011-12-15

We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

Transcatheter Arterial Embolization for Postpartum Hemorrhage with Disseminated Intravascular Coagulation: Outcome Assessment

International Nuclear Information System (INIS)

An, Eun Jung; Kim, Young Hwan; Kwon, Bo Ra; Kim, See Hyung

2011-01-01

We evaluated the efficacy and predictors of clinical outcome after transcatheter arterial embolization (TAE) for treatment of postpartum hemorrhage with disseminated intravascular coagulation (DIC). Of 127 patients who underwent TAE for postpartum hemorrhage, 46 progressed to DIC (group 1), 81 showed normal range hematological parameters (group 2). We retrospectively evaluated etiology, embolization methods and the efficacy of TAE for intergroup comparison Pearson Chi-Square test and logistic regression model. Overall TAE failed to control bleeding in 9 patients in spite of technical success. Lower bleeding control rate was found in group 2 (82.6%) relative to group 1 (98.8%, p = 0.001). And embolization methods were not statistically different between two groups no statistically significant predictors associated with failed hemostasis except the amount of transfusion in group 1. Although bleeding control rate is lower in postpartum hemorrhage with DIC than without DIC, we believe that TAE with correction of DIC is an effective method for postpartum hemorrhage with DIC.

COAGULATION ACTIVITY IN LIVER DISEASE

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Dr. Sheikh Sajjadieh Mohammad Reza

2009-07-01

Full Text Available Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation markers were assayed in 60 participants: 20 patients with chronic hepatitis, 20 patients with cirrhosis, and 20 healthy individuals (control. Plasma levels of anti-thrombin III were determined by a chromogenic substrate method, and plasma concentrations of fibrinogen were analyzed by the Rutberg method. Commercially available assays were used for laboratory coagulation tests. The levels of coagualation activity markers in patients with chronic liver disease were significantly different in comparison to those in healthy participants. These results indicate the utility of measuring markers for coagulation activity in determining which cirrhosis patients are more susceptible to disseminated intravascular coagulation.

Coagulation profile in patients undergoing video-assisted thoracoscopic lobectomy: A randomized, controlled trial.

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Thomas Decker Christensen

Full Text Available Knowledge about the impact of Low-Molecular-Weight Heparin (LMWH on the coagulation system in patients undergoing minimal invasive lung cancer surgery is sparse. The aim of this study was to assess the effect of LMWH on the coagulation system in patients undergoing Video-Assisted Thoracoscopic Surgery (VATS lobectomy for primary lung cancer.Sixty-three patients diagnosed with primary lung cancer undergoing VATS lobectomy were randomized to either subcutaneous injection with dalteparin (Fragmin® 5000 IE once daily or no intervention. Coagulation was assessed pre-, peri-, and the first two days postoperatively by standard coagulation blood test, thromboelastometry (ROTEM® and thrombin generation.Patients undergoing potential curative surgery for lung cancer were not hypercoagulable preoperatively. There was no statistically significant difference in the majority of the assessed coagulation parameters after LMWH, except that the no intervention group had a higher peak thrombin and a shorter INTEM clotting time on the first postoperative day and a lower fibrinogen level on the second postoperative day. A lower level of fibrin d-dimer in the LMWH group was found on the 1. and 2.postoperative day, although not statistical significant. No differences were found between the two groups in the amount of bleeding or number of thromboembolic events.Use of LMWH administered once daily as thromboprophylaxis did not alter the coagulation profile per se. As the present study primarily evaluated biochemical endpoints, further studies using clinical endpoints are needed in regards of an optimized thromboprophylaxis approach.

Effect of perioperative crystalloid or colloid fluid therapy on hemorrhage, coagulation competence, and outcome

DEFF Research Database (Denmark)

Rasmussen, Kirsten C; Secher, Niels H.; Pedersen, Tom

2016-01-01

Background: A meta-analysis concerning perioperative coagulation competence, hemorrhage, and outcome was conducted including the use of hydroxyethyl starches (HESs), dextran, or albumin versus administration of a crystalloid as control to assess the efficacy and safety of colloids and crystalloids...

Intensity of early correction of hyperglycaemia and outcome of critically ill patients with diabetic ketoacidosis.

Science.gov (United States)

Mårtensson, Johan; Bailey, Michael; Venkatesh, Balasubramanian; Pilcher, David; Deane, Adam; Abdelhamid, Yasmine Ali; Crisman, Marco; Verma, Brij; MacIsaac, Christopher; Wigmore, Geoffrey; Shehabi, Yahya; Suzuki, Takafumi; French, Craig; Orford, Neil; Kakho, Nima; Prins, Johannes; Ekinci, Elif I; Bellomo, Rinaldo

2017-09-01

To determine the impact of the intensity of early correction of hyperglycaemia on outcomes in patients with diabetic ketoacidosis (DKA) admitted to the intensive care unit. We studied adult patients with DKA admitted to 171 ICUs in Australia and New Zealand from 2000 to 2013. We used their blood glucose levels (BGLs) in the first 24 hours after ICU admission to determine whether intensive early correction of hyperglycemia to ≤ 180 mg/dL was independently associated with hypoglycaemia, hypokalaemia, hypo-osmolarity or mortality, compared with partial early correction to > 180 mg/dL as recommended by DKA-specific guidelines. Among 8553 patients, intensive early correction of BGL was applied to 605 patients (7.1%). A greater proportion of these patients experienced hypoglycaemia (20.2% v 9.1%; P < 0.001) and/or hypo-osmolarity (29.4% v 22.0%; P < 0.001), but not hypokalaemia (16.7% v 15.6%; P = 0.47). Overall, 11 patients (1.8%) in the intensive correction group and 112 patients (1.4%) in the partial correction group died (P = 0.42). However, after adjustment for illness severity, partial early correction of BGL was independently associated with a lower risk of hypoglycaemia (odds ratio [OR], 0.38; 95% CI, 0.30-0.48; P < 0.001), lower risk of hypo-osmolarity (OR, 0.80; 95% CI, 0.65-0.98; P < 0.03) and lower risk of death (OR, 0.44; 95% CI, 0.22-0.86; P = 0.02). In a large cohort of patients with DKA, partial early correction of BGL according to DKA-specific guidelines, when compared with intensive early correction of BGL, was independently associated with a lower risk of hypoglycaemia, hypo-osmolarity and death.

Activation of the coagulation cascade in patients with scrub typhus.

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Lee, Hee-Jeong; Park, Chi-Young; Park, Sang-Gon; Yoon, Na-Ra; Kim, Dong-Min; Chung, Choon-Hae

2017-09-01

This retrospective study aimed to evaluate the levels of coagulation factors and presence of disseminated intravascular coagulation (DIC) in patients with scrub typhus. We included patients confirmed to have scrub typhus at the Chosun University Hospital between September 2004 and December 2009. The DIC scores were evaluated in 365 patients and 36 healthy controls. The median concentrations of fibrinogen, d-dimer, and fibrin/fibrinogen degradation products (FDP) were compared between patients and healthy controls (pscrub typhus had longer prothrombin time and lower platelet counts than the controls. Major bleeding was observed in 18/365 patients with scrub typhus. Fifty-one (14.0%) patients presented with severe complications of scrub typhus. Overt DIC and thrombocytopenia (scrub typhus had overt DIC, as defined by the International Society on Thrombosis and Hemostasis DIC score (DIC1) and the DIC-scoring template with a fibrinogen/C-reactive protein-ratio (DIC2), respectively. Three (16.7%) and 10 (55.6%) patients with bleeding had overt DIC, as defined by the DIC1 and DIC2, respectively. Seven (13.7%) and 26 (51%) patients with severe illness had overt DIC, as defined by DIC1 and DIC2, respectively. In conclusion, activation of the coagulation system is an important feature of scrub typhus and is correlated with severe disease, including bleeding. This is the first study to report a relationship between DIC and scrub typhus. Copyright © 2017 Elsevier Inc. All rights reserved.

Peculiarities of coagulation hemostasis disorders in patients with chronic obstructive pulmonary disease

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Yakovlieva V.H.

2015-09-01

Full Text Available The violation of blood coagulation properties is observed in many diseases of the respiratory system, including chronic obstructive pulmonary disease (COPD. It is known that in a stable COPD phase release of proinflammatory cytokines in blood is observed, it leads to disturbance of hemostasis parameters toward hypercoagulation. The aim of our study was to determine possibility of coagulation disorders formation in patients with COPD in a stable phase of pathological process at different stages of disease course and identify relationship between coagulation parameters levels and degree of violation of ventilation lung function. Materials and methods. We examined 30 patients with COPD in a stable disease phase, included in the main group (FEV1 =49,5±15,5% of the due, there were 27 men (90.0%, 3 (30.0% women, mean age was 61,8±7,9 years, level of pack /years index - 34,2±15,3. The control group consisted of 10 healthy subjects matched with the patients of the main group by age and sex. All patients were divided into 2 subgroups. Subgroup 1 included 16 patients with moderate COPD, that is the level of FEV1>50% (61,8±7,4% of predicted, and subgroup 2 - 14 COPD patients with severe COPD, that is the level of FEV1 <50% (35,3±8,2% of predicted. Patients received standard treatment according to the disease stage. Main indicators of coagulation levels: prothrombin index (PI, prothrombin ratio (PR, international normalized ratio (INR, activated partial thromboplastin time (APTT, thrombin time (TT and antithrombin III (AT III were identified in all patients. Results. The levels of PI, PR and INR in the subgroup 1 differed significantly from those of in the subgroup 2, control group (p<0,05 and pointed at hypercoagulation, whereas in the subgroup 2 all indicators were absolutely identical with control group. Correlation link between the level of INR levels and FEV1 (r=-0,73; p<0.01 in patients of the main group was determined. Levels of APTT, TT and AT

Coagulation system changes associated with susceptibility to infection in trauma patients.

Science.gov (United States)

Cole, Elaine; Davenport, Ross; De'Ath, Henry; De-Ath, Henry; Manson, Joanna; Brockamp, Thomas; Brohi, Karim

2013-01-01

Infection following trauma is associated with increased morbidity and mortality and is common following severe hemorrhage. There is a strong interaction between the coagulation and immunity. The objective of this study was to establish if there was an association between changes in coagulation status after hemorrhage and the subsequent incidence of infection. Prospective cohort study of adult injured patients presenting to a major trauma center during a 2-year period. Blood was drawn at 24 hours following admission and analyzed using functional thromboelastography testing and laboratory defined tests of coagulation and blood count. Patients were followed up for infectious episodes while in the hospital using Center for Disease Control definitions. A total of 158 patients were recruited; 71 (45%) developed infection and were older (44 years vs. 32 years, p = 0.01) and more severely injured (Injury Severity Score [ISS], 25 vs.10; p < 0.01). White blood cell counts at 24 hours were normal, and there was no difference between groups (both 9.6 × 10/(9)L). Protein C was lower in those with infection (70.2 IU/dL vs. 83.3 IU/dL, p = 0.02), with a dose-dependent increase in infection as levels of protein C decreased. Plasmin activation at 24 hours was also strongly associated with infection plasmin-antiplasmin (infection vs. no infection, 6,156 μg/L vs. 3,324 μg/L, p = 0.03). The infection cohort had overall 12% lower procoagulant levels (varied between factor VIII 6.4% and factor II 16.2%). There is a strong association between the status of the coagulation system after 24 hours and the development of infection following trauma. Improved early coagulation management may decrease infection rates in this patient group. Prognostic prospective study, level III.

Coagulation disorders in the patients with deep vein thrombosis of lower extremity

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Milić Dragan J.

2003-01-01

Full Text Available PURPOSE Venous thromboembolism is a relevant social and health care problem for its high incidence, pulmonary embolism-related mortality and long-term sequelae which may be disabling (post-thrombotic syndrome and ulceration. PROCEDURES The aim of our work was to establish the presence of coagulation disorders (hypercoagulable states in the patients with deep vein thrombosis (DVT of the leg. Prospectively we have analyzed a group of 30 patients with echosono-graphicaly verified DVT of the leg who were admitted to the department of vascular surgery from August 1st 2000 to July 31st 2001.The following parameters were monitored: prothrombin time (PT partial thromboplastin time (PTT, fibrinogen (Fib, alpha 2 antiplasmin (A-2 AP, D-dimer (DD, antithrombin III (AT III and factor VII. FINDINGS Activation of the coagulation process was registered. The values of monitored coagulation parameters are shown in table 1. Plasma levels of monitored parameters in the patients with DVT of the leg were significantly higher than in the control subjects. CONCLUSION In patients with a DVT a hypercoagulable state is common finding. Some parameters of coagulation activity such as D-dimer might be of great interest in the diagnostic strategy of DVT.

Suspected ontogeny of a recently described hypo-androgenic PCOS-like phenotype with advancing age.

Science.gov (United States)

Gleicher, Norbert; Kushnir, Vitaly A; Darmon, Sarah K; Wang, Qi; Zhang, Lin; Albertini, David F; Barad, David H

2018-03-01

A recent report described a new PCOS-like phenotype in lean older infertile women, and was characterized by high age-specific anti-Müllerian hormone (AMH) but hypo- rather than the expected hyper-androgenism. The hypo-androgenism was, furthermore, characterized of, likely, adrenal origin and autoimmune etiology. We extracted data on 708 consecutive infertility patients, and separated them into three age-strata, 42 years. In each stratum, we investigated how levels of anti-Müllerian hormone (AMH) and testosterone (T) interrelate between high-AMH (AMH ≥ 75th quantile) and normal AMH (25th-75th quantile) and low-T (total testosterone ≤19.0 ng/dL), normal-T (19.0-29.0 ng/dL) and high-T (>29.0 ng/dL). High-AMH cycles were presumed to reflect PCOS-like patients. Routine in vitro fertilization (IVF) cycle outcomes and clinical phenotypes of patients were then compared between groups with AMH and T as statistical variables. This hypo-androgenic PCOS-like phenotype already exists in age stratum androgenic PCOS phenotype that develops in comparison to controls (likely autoimmune-induced) insufficiency of the adrenal zona reticularis (low-T and low-DHEAS) and zona fasciculata (low-C), and is characterized by frequent evidence of autoimmunity. A degree of adrenal insufficiency, thus, concomitantly appears to affect adrenal androgen and, to lesser degrees, glucocorticoid production (mineralocorticoids were not investigated). Here investigated new PCOS-like phenotype demonstrates features compatible with what under Rotterdam criteria has been referred to as PCOS phenotype-D. If confirmed, the observation that the ontogeny of this phenotype already at young ages is, likely, driven by adrenal autoimmunity, supports the position of the androgen excess and PCOS society that the etiology of phenotype-D differs from that of classical hyper-androgenic PCOS of mostly ovarian etiology.

The hypo-fractionated radiotherapy in the treatment of the prostate cancer: Radiate less to treat more

International Nuclear Information System (INIS)

Boissier, R.; Gross, E.

2012-01-01

The principle of the hypo-fractionation in radiotherapy is to deliver a higher dose by session and to reduce the duration of treatment. In the particular case of the cancer of prostate, a hypo-fractionated protocol allows to deliver an equivalent radiobiological dose identical even higher than a standard plan of irradiation. The hypo-fractionation is presented as a solution to improve the access to the care (fewer processing times by patient, more patients treated by machine) while increasing the quality of the care: better carcinological control, less radiotoxicity. The objective of this article is to make a clarification on the hypo-fractionated radiotherapy in first intention in the treatment of the localized prostate cancer. We count three studies on large cohorts, comparing standard plans to 1.8 2 Gy/session and hypo-fractionated plans (2.5 3 Gy/session). The inferior carcinological results of the two first comparative studies with regard to the study of phase I/II of the Cleveland clinic were owed to a sub-dosage of hypo-fractionated plans. The administered equivalent biological doses were lower than the at present recommended total doses and lower than the theoretical doses, calculated on the bases of an erroneous evaluation of the radio-sensibility of the prostate cancer. In the comparative study of Arcangeli, the rate of survival without biological recurrence in 4 years (82%) was significantly to the advantage of the hypo-fractionated group, while reducing the duration of treatment of 3 weeks. Four comparative studies reported acute/late toxicity, gastrointestinal (GI)/genito-urinary acceptable (GU) even lower with a hypo-fractionated plan. The hypo-fractionation is potentially the future of the radiotherapy in the treatment of the localized prostate cancer thanks to the technological innovation, but for all that does not constitute at present a standard. (authors)

Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinical trial.

OpenAIRE

Templeton, J L; Spence, R A; Kennedy, T L; Parks, T G; Mackenzie, G; Hanna, W A

1983-01-01

One hundred and thirty seven previously untreated out-patients with first and second degree haemorrhoids were allocated at random to treatment by infrared coagulation (n=66) or rubber band ligation (n=71). Complete follow up was obtained in 122 patients (60 who had undergone infrared coagulation (group 1), and 62 rubber band ligation (group 2)) at periods from three months to one year after completion of treatment. Infrared coagulation produced a satisfactory outcome in 51 patients (85%): 34 ...

Risk of disseminated intravascular coagulation in patients undergoing US-guided transperineal prostatic biopsy

International Nuclear Information System (INIS)

Stella, M.S.; Comparato, D.; Camici, M.; Evangelisti, L.; Gaudio, V.; De Negri, F.; Talarico, L.; Giusti, C.; Morelli, G.

1991-01-01

Disseminated intravascular coagulation (DIC) is a severe life-threatening acute bleeding disorder. Traumatized tissues, tumors, necrotic tissues, or bacterial endotoxines release similar material in the blood to the tissutal factors activating the coagulation cascade. This preliminary study was aimed at verifying the risk of DIV in patients undergoing US-guided transperineal prostatic biopsy with Chiba and Tru-Cut needles. To evaluate the activation degree of coagulation factors in the circulation, the authors measured the concentrations of urinary fibrin degradation products in 10 patients undergoing US-guided transperineal prostatic biopsy, both before and after biopsy, every second hour, for 24 hours. Every tube of urine sample contained soya bean trypsin inhibitor and bovine thrombin to prevent any further fibrin degradation during incubation period for the possible presence of blood in urine samples. The results showed that 7/10 patients had marked increase in urinary fibrin degradation product levels (up to 800 XXXX%), with a 3-phase trend: early peak after 2-6 hours, middle peak after 6-14 hours, and late peak after 18-24 hours, which proved the activation of the coagulation cascade

A short-term study of corneal collagen cross-linking with hypo-osmolar riboflavin solution in keratoconic corneas

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Shao-Feng Gu

2015-02-01

Full Text Available AIM: To report the 3mo outcomes of collagen cross-linking (CXL with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium. METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure. RESULTS: The mean thinnest thickness of the cornea was 408.5±29.0 μm before treatment and reduced to 369.8±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0±26.5 μm before CXL and recover to 412.5±22.7 μm at 3mo after treatment, P=0.659. Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6±4.0 diopters, and slightly decreased (54.7±4.9 diopters after surgery (P=0.085. Mean best-corrected visual acuity was 0.55±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery (P=0.879. The endothelial cell density was 2706.4±201.6 cells/mm2 before treatment, and slightly decreased (2641.2±218.2 cells/mm2 at last fellow up (P=0.002. CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.

Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinical trial.

Science.gov (United States)

Templeton, J L; Spence, R A; Kennedy, T L; Parks, T G; Mackenzie, G; Hanna, W A

1983-01-01

One hundred and thirty seven previously untreated out-patients with first and second degree haemorrhoids were allocated at random to treatment by infrared coagulation (n=66) or rubber band ligation (n=71). Complete follow up was obtained in 122 patients (60 who had undergone infrared coagulation (group 1), and 62 rubber band ligation (group 2)) at periods from three months to one year after completion of treatment. Infrared coagulation produced a satisfactory outcome in 51 patients (85%): 34 were rendered asymptomatic and 17 improved. Rubber band ligation produced a satisfactory outcome in 57 patients (92%): 33 were rendered asymptomatic and 24 improved. Both methods were equally effective in first and second degree haemorrhoids. The incidence of side effects, particularly discomfort, during and after treatment was significantly higher in those treated by rubber band ligation (p less than 0.001). This appeared to be an appreciable deterrent to future patient compliance. The number of patients losing more than 24 hours from work was higher after rubber band ligation than after infrared coagulation. The number of treatments necessary to cure symptoms did not differ significantly between the two methods. Infrared coagulation was significantly faster than rubber band ligation (p less than 0.001). Infrared coagulation is a simple, fast, and effective outpatient method for the treatment of first and second degree haemorrhoids with fewer troublesome side effects and higher patient acceptability than rubber band ligation. PMID:6404471

Tcp and NTCP radiobiological models: conventional and hypo fractionated treatments in radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Astudillo V, A.; Paredes G, L. [ININ, Carretera Mexico-Toluca s/n, Ocoyoacac 52750, Estado de Mexico (Mexico); Resendiz G, G.; Posadas V, A. [Hospital Angeles Lomas, Av. Vialidad de la Barranca s/n, Col. Valle de las Palmas, 52763 Huixquilucan de Degallado, Estado de Mexico (Mexico); Mitsoura, E. [Universidad Autonoma del Estado de Mexico, Facultad de Medicina, Paseo Tollocan, Esq. Jesus Carranza s/n, Col. Moderna de la Cruz, 50180 Toluca, Estado de Mexico (Mexico); Rodriguez L, A.; Flores C, J. M., E-mail: armando.astudillo@inin.gob.mx [Hospital Medica Sur, Puente de Piedra 150, Col. Toriello Guerra, 14050 Tlalpan, Mexico D. F. (Mexico)

2015-10-15

The hypo and conventional fractionated schedules performance were compared in terms of the tumor control and the normal tissue complications. From the records of ten patients, treated for adenocarcinoma and without mastectomy, the dose-volume histogram was used. Using radiobiological models the probabilities for tumor control and normal tissue complications were calculated. For both schedules the tumor control was approximately the same. However, the damage in the normal tissue was larger in conventional fractionated schedule. This is important because patients assistance time to their fractions (15 fractions/25 fractions) can be optimized. Thus, the hypo fractionated schedule has suitable characteristics to be implemented. (Author)

Tcp and NTCP radiobiological models: conventional and hypo fractionated treatments in radiotherapy

International Nuclear Information System (INIS)

Astudillo V, A.; Paredes G, L.; Resendiz G, G.; Posadas V, A.; Mitsoura, E.; Rodriguez L, A.; Flores C, J. M.

2015-10-01

The hypo and conventional fractionated schedules performance were compared in terms of the tumor control and the normal tissue complications. From the records of ten patients, treated for adenocarcinoma and without mastectomy, the dose-volume histogram was used. Using radiobiological models the probabilities for tumor control and normal tissue complications were calculated. For both schedules the tumor control was approximately the same. However, the damage in the normal tissue was larger in conventional fractionated schedule. This is important because patients assistance time to their fractions (15 fractions/25 fractions) can be optimized. Thus, the hypo fractionated schedule has suitable characteristics to be implemented. (Author)

Comparison of clinical and laboratory parameters in patients with end-stage renal failure in the outcome of chronic glomerulonephritis and patients with end-stage renal failure in the outcome of other diseases.

Science.gov (United States)

Popova, J A; Yadrihinskaya, V N; Krylova, M I; Sleptsovа, S S; Borisovа, N V

frequent complications of hemodialysis treatments are coagulation disorders. This is due to activation of the coagulation of blood flow in the interaction with a dialysis membrane material vascular prostheses and extracorporeal circuit trunks. In addition, in hemodialysis patients receiving heparin for years, there is depletion of stocks in endothelial cells in tissue factor inhibitor, inhibits the activity of an external blood clotting mechanism. the aim of our study was to evaluate the hemostatic system parameters in patients with end-stage renal failure, depending on the cause of renal failure. to evaluate the hemostatic system parameters in patients with end-stage renal failure, depending on the cause of renal failure and hemodialysis treatment duration conducted a study that included 100 patients observed in the department of chronic hemodialysis and nephrology hospital №1 Republican National Medical Center in the period of 2013-2016. in patients with end-stage renal failure in the outcome of chronic glomerulonephritis, a great expression of activation of blood coagulation confirm increased the mean concentration of fibrinogen, whereas in the group, which included patients with end-stage renal failure in the outcome of other diseases, such is not different from the norm, and a higher rate of hyperfibrinogenemia, identified in 2/3 patients in this group. it was revealed that the state of homeostasis in patients with end-stage renal failure in increasingly characterizes the level of fibrinogen and the activation of the hemostatic markers: soluble fibrin monomer complexes, D-dimers.

Hypo fractionated prostate treatment by volumearcotherapy modulated; Tratamiento hipofraccionado de prostata mediante arcoterapia volumetria modulada

Energy Technology Data Exchange (ETDEWEB)

Clemente Gutierrez, F.; Perez Vara, C.; Prieto Villacorta, M.

2013-07-01

Several studies have been proposed over the years schemes of hypo-fractionated treatment for prostate cancer. Such schemes have been designed in order to increase local control of the disease and reduce complications. They are in addition a clear improvement from the point of view logistical and organizational for treatment centres and the patient. the hypo-fractionated treatments are possible because the ratio a/b for prostate carcinoma is comparable, and even below, the surrounding healthy tissues. This work presents the scheme adopted in our Center for the hypo-fractionated treatment of the cancer of prostate by arco therapy volumetric modulated. (Author)

Analysis of the Factors Associated with Abnormal Coagulation and Prognosis
in Patients with Non-small Cell Lung Cancer

Directory of Open Access Journals (Sweden)

Yanhua LI

2014-11-01

Full Text Available Background and objective The activation of coagulation and fibrinolysis is frequently encountered among cancer patients. Such tumors are associated with high risk of invasion, metastases, and negative final outcomes. Non-small cell lung cancer (NSCLC accounts for approximately 80% to 85% of all lung malignancies. This study aims to investigate the prognostic value of blood coagulation tests for NSCLC and provide a reference to patients on the prevention and treatment of thrombophilia. Methods Data were collected from 604 cases of hospitalized patients with histologically confirmed NSCLC from January 2009 to December 2012 at the Fourth Hospital of Hebei Medical University. Data included the related indexes of coagulation function in patients before treatment [(i.e., prothrombin time (PT, prothrombin time activity (PTA, international normalized ratio (INR, activated partial thromboplastin time (APTT, fibrinogen (Fib, D-dimer, and platelet count], as well as sex, age, pathological type, TNM stage, and lymph node status. Fifty control subjects without cancer were included in the analysis. Statistical analysis was conducted by using SPSS 13.0 software. Results The plasma level of all coagulation tests including D-dimer, Fib, PT, APTT, INR, and platelet counts revealed statistically significant differences between the patient and control group (P<0.001 for all variables; P=0.001,5 and P=0.004,5 for Fib and platelet counts, respectively. The squamous subtype exhibited high plasma Fib levels (P<0.001 compared with adenocarcinoma cell lung cancer patients. Fib and PLT levels increased (P<0.001 and P=0.014, respectively, and aPTT decreased (P<0.001 in patients at stages III and IV compared with those in patients at stages I and II. aPTT decreased significantly (P<0.001, and Fib and D-dimer levels increased (P<0.001 and P=0.048, respectively in N1-3 patients with NSCLC compared with those of N0 patients. Prolonged PT and INR, high plasma Fib levels, and

Coagulation abnormalities in patients with chronic liver disease in Pakistan

International Nuclear Information System (INIS)

Siddiqui, S.A.; Ghani, M.H.; Ghori, M.A.; Ahmed, M.

2011-01-01

Objective: To determine the coagulation abnormalities and relationship between abnormal clotting tests and the risk of gastrointestinal bleeding (GI) among chronic liver disease (CLD) patients admitted at a tertiary care hospital in Pakistan. Methods: Adult CLD patients admitted at Liaquat University Hospital Jamshoro, during Nov 2004 - Oct 2005, were included in the study. The patients blood were tested for coagulation abnormalities including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count and plasma fibrinogen. Association was seen between the abnormal clotting tests and the gastrointestinal bleeding by calculating relative risk (RR) with 95% confidence interval. Results: PT was prolonged in 88% and aPTT was raised in 71% cases of CLD. Both PT and aPTT were prolonged in 67% CLD cases. Approximately 37% CLD cases had decreased platelet count and 15% cases had decreased serum fibrinogen level. Relative risk of GI bleeding with abnormal clotting tests in CLD cases were weakly positive for PT (RR = 1.02; 95% CI, 0.49-2.10), negative for aPTT (RR=0.83; 95% CI, 0.47-1.45), strongly positive for decreased platelet counts (RR = 1.96; 95% CI, 1.08-3.56) and also for decreased fibrinogen level (RR = 1.47; 95% CI, 0.64-3.35). Conclusion: Coagulation abnormalities were profound in CLD. Decrease platelet counts and fibrinogen levels were related with GI bleeding but PT and aPTT were not significantly related with GI bleeding in patients with chronic liver disease. Nevertheless, these parameters (PT and aPTT) were still used as prognostic markers. (author)

Correlation between thromboelastography and traditional coagulation test parameters in hospitalized dogs

Directory of Open Access Journals (Sweden)

Rubanick JV

2017-02-01

Full Text Available Jean V Rubanick, Medora B Pashmakova, Micah A Bishop, James W Barr Department of Veterinary Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA Abstract: A hospital-based, prospective cross-sectional study was used to compare kaolin-activated thromboelastography (TEG parameters with traditional coagulation tests in 29 hospitalized dogs. Cases were included if the attending clinician requested coagulation testing. Blood was obtained from each dog and coagulation (prothrombin time, partial thromboplastin time, antithrombin activity, d-dimer concentration, and fibrinogen concentration and TEG analyses were performed. Hematocrit (Hct was also measured. Traditional coagulation results were evaluated for correlation with those from kaolin-activated TEG. Spearman’s correlation was used to calculate correlation coefficients. Fibrinogen was positively correlated with maximum amplitude (Pearson r=0.72, P<0.001 and global clot strength (Pearson r=0.72, P<0.001. There was no correlation between any of the remaining coagulation variables, TEG parameters, or Hct. Results of kaolin-activated TEG and traditional coagulation tests are not interchangeable means of monitoring coagulation derangements in this intensive care unit patient population. Determination of a true outcome measure is necessary to establish TEG’s clinical relevance to veterinary medicine. Keywords: TEG, thromboelastography, coagulation, hemostasis

Reporting combined outcomes with Trifecta and survival, continence, and potency (SCP) classification in 337 patients with prostate cancer treated with image-guided hypofractionated radiotherapy.

Science.gov (United States)

Jereczek-Fossa, Barbara A; Zerini, Dario; Fodor, Cristiana; Santoro, Luigi; Maucieri, Andrea; Gerardi, Marianna A; Vischioni, Barbara; Cambria, Raffaella; Garibaldi, Cristina; Cattani, Federica; Vavassori, Andrea; Matei, Deliu V; Musi, Gennaro; De Cobelli, Ottavio; Orecchia, Roberto

2014-12-01

To report the image-guided hypofractionated radiotherapy (hypo-IGRT) outcome for patients with localised prostate cancer according to the new outcome models Trifecta (cancer control, urinary continence, and sexual potency) and SCP (failure-free survival, continence and potency). Between August 2006 and January 2011, 337 patients with cT1-T2N0M0 prostate cancer (median age 73 years) were eligible for a prospective longitudinal study on hypo-IGRT (70.2 Gy/26 fractions) in our Department. Patients completed four questionnaires before treatment, and during follow-up: the International Index of Erectile Function-5 (IIEF-5), the International Prostate Symptom Score (IPSS), and the European Organization for Research and Treatment of Cancer prostate-cancer-specific Quality of Life Questionnaires (QLQ) QLQ-PR25 and QLQ-C30. Baseline and follow-up patient data were analysed according to the Trifecta and SCP outcome models. Cancer control, continence and potency were defined respectively as no evidence of disease, score 1 or 2 for item 36 of the QLQ-PR25 questionnaire, and total score of >16 on the IIEF-5 questionnaire. Patients receiving androgen-deprivation therapy (ADT) at any time were excluded. Trifecta criteria at baseline were met in 72 patients (42% of all ADT-free patients with completed questionnaires). Both at 12 and 24 months after hypo-IGRT, 57% of the Trifecta patients at baseline were still meeting the Trifecta criteria (both oncological and functional success according to the SCP model). The main reason for failing the Trifecta criteria during follow-up was erectile dysfunction: in 18 patients after 6 months follow-up, in 12 patients after 12 months follow-up, and in eight patients after 24 months. Actuarial 2-year Trifecta failure-free survival rate was 44% (95% confidence interval 27-60%). In multivariate analysis no predictors of Trifecta failure were identified. Missing questionnaires was the main limitation of the study. The Trifecta and SCP

Using the Electronic Medical Record to Reduce Unnecessary Ordering of Coagulation Studies for Patients with Chest Pain

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Jeremiah S. Hinson

2017-02-01

Full Text Available Introduction: Our goal was to reduce ordering of coagulation studies in the emergency department (ED that have no added value for patients presenting with chest pain. We hypothesized this could be achieved via implementation of a stopgap measure in the electronic medical record (EMR. Methods: We used a pre and post quasi-experimental study design to evaluate the impact of an EMRbased intervention on coagulation study ordering for patients with chest pain. A simple interactive prompt was incorporated into the EMR of our ED that required clinicians to indicate whether patients were on anticoagulation therapy prior to completion of orders for coagulation studies. Coagulation order frequency was measured via detailed review of randomly sampled encounters during two-month periods before and after intervention. We classified existing orders as clinically indicated or non-value added. Order frequencies were calculated as percentages, and we assessed differences between groups by chi-square analysis. Results: Pre-intervention, 73.8% (76/103 of patients with chest pain had coagulation studies ordered, of which 67.1% (51/76 were non-value added. Post-intervention, 38.5% (40/104 of patients with chest pain had coagulation studies ordered, of which 60% (24/40 were non-value added. There was an absolute reduction of 35.3% (95% confidence interval [CI]: 22.7%, 48.0% in the total ordering of coagulation studies and 26.4% (95% CI: 13.8%, 39.0% in non-value added order placement. Conclusion: Simple EMR-based interactive prompts can serve as effective deterrents to indiscriminate ordering of diagnostic studies. [West J Emerg Med. 2017;18(2267-269.

[Perioperative changes of coagulation functions in the local advanced liver cancer patients receiving liver transplantation].

Science.gov (United States)

Wang, Hao-Yuan; Zhao, Qing-Yu; Yuan, Yun-Fei

2008-07-01

Liver transplantation is widely accepted as an effective therapy of hepatoma. Perioperative dynamic observation of coagulation function is important for graft-receivers. This study was to explore perioperative changes of coagulation functions in the local advanced liver cancer patients who received liver transplantation. Clinical data of 31 local advanced liver cancer patients, underwent liver transplantation from Sep. 2003 to Jan. 2007, were analyzed. Platelet (PLT) counting, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fib) and international normalized ratio (INR) before operation, at anhepatic phase and the first week after operation were analyzed to evaluate congulation function. The coagulation functions of most patients were normal before operation. The six parameters varied significantly at anhepatic phase and on most days of the first week after operation when compared with the preoperative levels (Pfunctions of local advanced liver cancer patients shift from hypocoagulatory to hypercoagulatory or normal in perioperative period, therefore, prevention of bleeding should be focused on at anhepatic phase and on 1-2 days after operation while prevention of thrombosis should be focused on after the first week after operation. The degree of liver cirrhosis and Child-Pugh level could help to evaluate postoperative coagulation disorder.

Factors Affecting Outcome in Treatment of Chronic Subdural Hematoma in ICU Patients: Impact of Anticoagulation.

Science.gov (United States)

Szczygielski, Jacek; Gund, Sina-Maria; Schwerdtfeger, Karsten; Steudel, Wolf-Ingo; Oertel, Joachim

2016-08-01

The use of anticoagulants and older age are the main risk factors for chronic subdural hematoma (CSDH). Because the age of the population and use of anticoagulants are increasing, a growing number of CSDH cases is expected. To address this issue, we analyzed the impact of anticoagulants on postsurgical outcome in patients in the intensive care unit (ICU). Demographic data, coagulation parameters, surgical details, radiologic appearance of hematoma, Glasgow Coma Scale (GCS) score on admission, and Glasgow Outcome Scale (GOS) score on discharge were retrieved and retrospectively analyzed in 98 patients with CSDH treated in the neurosurgical ICU using correlation coefficient tests and multivariate analysis test. Overall outcome was good (GOS score 4 and 5) in 55.1% of patients. Overall mortality was 9.1%. There was a correlation between GCS score on admission and GOS score. There was no correlation between hematoma thickness/radiologic appearance and impaired coagulation. Disturbance in thrombocyte function (usually resulting from aspirin intake) correlated with improved outcome, whereas warfarin-related coagulopathy correlated with poor recovery. Nevertheless, patients with thrombocytopathy presented with better initial GCS scores. Neither hematoma size nor recurrence rate affected the outcome. The size of CSDH was not associated with poor outcome and is not necessarily determined by the use of anticoagulants. Coagulopathy does not rule out a good outcome, but the impact of anticoagulation on treatment results in CSDH varies between the main groups of drugs (warfarin vs. antiplatelet drugs). Patients in good neurologic condition on ICU admission have better chances of recovery. Copyright © 2016 Elsevier Inc. All rights reserved.

Coagulation Profile in Patients with Different Etiologies for Cushing Syndrome: A Prospective Observational Study.

Science.gov (United States)

Tirosh, Amit; Lodish, Maya; Lyssikatos, Charalampos; Belyavskaya, Elena; Feelders, Richard A; Stratakis, Constantine A

2017-05-01

Previous studies reported a higher prevalence of venous-thromboembolic events among patients with Cushing disease (CD) compared to those with ACTH-independent Cushing syndrome (CS) from adrenal sources. The objective of the current study was to evaluate the coagulation profile of patients with CS from different etiologies. A prospective observational study was conducted at a clinical research center. The study included adult patients admitted for evaluation of suspected CS (n=85), that were divided into 3 groups: CD (n=22), ACTH-independent CS from an adrenal tumor/hyperplasia (adrenal CS, n=21), and a control group consisting of subjects with negative screening for CS (rule-out CS, n=42). Coagulation profiles were drawn before and 8.5±4.3 months after surgery (trans-sphenoidal or adrenalectomy, n=18), and included fibrinogen, Factor VIII (FVIII), von Willebrand factor antigen (vWF:Ag), plasminogen activator inhibitor-1 (PAI-1), antithrombin III (ATIII), Protein C (PC), Protein S (PS), α2-antiplasmin (α2AP), and aPTT measurements. Patients with CD had higher baseline mean cortisol levels, ATIII activity and vWF:Ag levels compared with adrenal CS. Differences in ATIII activity and vWF:Ag levels remained even after controlling for BMI, and ATIII after also controlling for 24-h urinary free cortisol collections. Our study showed for the first time the differences in coagulation profiles between various etiologies of CS. We assume that the higher cortisol burden among CD patients may explain the differences found in the coagulation profile as well as the higher risk for VTE compared with primary adrenal CS patients. © Georg Thieme Verlag KG Stuttgart · New York.

Over one thousand patients with early stage endometriosis treated with the Helica Thermal Coagulator (HELICA): safety aspects.

Science.gov (United States)

Hill, Nicholas; McQueen, John; Morey, Richard; Hanna, Leila; Chandakas, Stefanos; El-Toukhy, Tarek; Erian, John

2006-07-01

To assess the safety of the Helica Thermal Coagulator in the laparoscopic treatment of early stage endometriosis. Retrospective, observational. The Princess Royal University Hospital, The Sloane and Chelsfield Park Hospitals, Kent, UK. One thousand and sixty patients with early stage endometriosis. All patients were treated laparoscopically with the Helica Thermal Coagulator; a new laparoscopic device that combines electrical energy with helium for the treatment of endometriosis. No major bladder, ureteric or bowel injuries occurred. The only complication was a perforated vagina from the cutting probe during dissection of the cul-de-sac in a patient with a vaginal endometriotic nodule. The Helica Thermal Coagulator is a safe device for the laparoscopic treatment of endometriosis.

The use of cold coagulation for the treatment of cervical intraepithelial neoplasia

LENUS (Irish Health Repository)

Wyse, A

2017-05-01

In 2015, Cold Coagulation was introduced as a treatment for cervical intraepithelial neoplasia (CIN) at our colposcopy clinic. We reviewed the 6-month follow up data of the first 200 women who underwent Cold Coagulation using cytology and HPV status as tests of cure (TOC). A random sample of 200 patients treated by Large Loop Excision of the Transformation Zone (LLETZ) during the same period was used to compare treatment outcome. Six months following treatment,173 (86.5%) of the women treated by CC and 167 (83.5%) treated by LLETZ had negative cytology. (x2= P>0.05). 148 (74%) treated by Cold Coagulation and 166 (83%) treated by LLETZ were HPV negative (x2= P<0.05). One hundred and thirty-nine (70%) women treated by Cold Coagulation and 152 (76%) treated with LLETZ had normal cytology and were HPV negative. This audit of our initial experience supports the observation that Cold Coagulation is as effective as LLETZ in the management of CIN when cervical cytology is used as a test of cure.

Blood Coagulation and Acid-Base Balance at Craniocerebral Hypothermia in Patients with Severe Traumatic Brain Injury

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V. E. Avakov

2015-01-01

Full Text Available Systemic therapeutic hypothermia has gained a negative reputation in treating multiple trauma patients and is regarded as one of the factors in the lethal triad of shock, acidosis, and hypothermia. This fact owes to no relationship between acidosis and hypothermia; the effects of the latter on coagulation are evident and complexly reversible in the presence of acidosis.Objective: to determine the impact of noninvasive local brain cooling on the metabolic and blood coagulation indicators of a patient with acute cerebral ischemia.Subjects and methods. The subjects of the study were 113 patients with severe brain injury, including that complicated by the involvement of stem structures, who underwent brain cooling in different modifications. In so doing, the val ues of acidbase balance and coagulation system in arterial and venous blood were investigated.Results. Local brain hypother mia was not found to affect coagulation while the baseline negative values of excess buffer bases showed positive values (a right shift by the end of cooling. Recommendations were given to prevent metabolic shifts.Conclusion. Patients at very high risk for bleeding may be safely cooled to a brain temperature of 32—34°C even in the presence of moderatetosevere acidosis. This is a great advantage of local hypothermia over systemic one.

C-reactive protein in patients with acute coronary syndrome: association with coronary markers, lipid profile and markers of coagulation

International Nuclear Information System (INIS)

Munir, T.A.; Afzal, M.N.

2010-01-01

To determine levels of C-reactive protein (CRP) and its association with coronary markers, lipid profile and markers of coagulation in patients of acute coronary syndrome (ACS). The study was conducted at Shifa college of Medicine and Shifa international hospital for a period of one year (November 2005-December 2006). Patients and Methods: Sixty nine age matched controls and 133 consecutive patients of ACS were included in the study. CRP were measured by immunoturbidometric method, MB fraction of creatine kinase (CK-MB) and Troponin-1 by micro-particle enzyme immunoassay, lipid levels by Colorimetric Enzymatic methods, platelets by celldyn and coagulation markers were measured by CA-50 Sysmax. At admission mean CRP levels, cardiac biomarkers, lipid profile and coagulation markers were significantly increased in patients of ACS versus controls. Within the patients of ACS the mean levels of CRP, CK-MB, Trop I, prothrombin time (PT) and activated partial thromboplastin time (Am) were significantly raised in patients with ST - elevation myocardial infarction (STEMI) and non STEMI (NSTEMI) versus patients of unstable angina (VA). Association between CRP levels and coronary markers, coagulation markers and lipid profile was found to be non significant. The CRP levels were increased in patients with ACS as compared to controls. The CRP levels were insignificantly correlated with coronary markers (CK-MB, Trop I), coagulation markers (platelet count, PT, Am), and lipid profile (cholesterol, triglyceride, HDL and LDL cholesterol) in patients with ACS. (author)

Effects of transient hypo- and hyper-thyroidism on growth ...

African Journals Online (AJOL)

In order to investigate the effects of transient hypo- and hyperthyroidism on growth performance, organ weights and serum thyroid hormones of broilers, 120 one-day-old broiler chicks were randomly divided into four dietary treatments for six weeks. The dietary treatments included: 1) control, 2) hypothyroid (hypo; ...

Coagulation profile of children with sickle cell anemia in steady state ...

African Journals Online (AJOL)

Background: Sickle cell anemia is associated with a hypercoagulable state that may lead to alterations in a coagulation profile. Measurements of coagulation factors are known to have some predictive value for clinical outcome. Objectives: To determine the coagulation profile of children with SCA in steady state and crisis ...

Artificial liver support with the molecular adsorbent recirculating system: activation of coagulation and bleeding complications.

Science.gov (United States)

Bachli, Esther B; Schuepbach, Reto A; Maggiorini, Marco; Stocker, Reto; Müllhaupt, Beat; Renner, Eberhard L

2007-05-01

Numerous, mostly uncontrolled, observations suggest that artificial liver support with the Molecular Adsorbent Recirculating System (MARS) improves pathophysiologic sequelae and outcome of acute and acute-on-chronic liver failure. MARS is felt to be safe, but extracorporeal circuits may activate coagulation. To assess the frequency of and risk factors for activation of coagulation during MARS treatment. Retrospective analysis of coagulopathy/bleeding complications observed during 83 consecutive MARS sessions in 21 patients (11 men; median age 46 years; median three sessions per patient; median duration of session 8 h). Nine clinically relevant episodes of coagulopathy/bleeding were observed in eight patients, forced to premature cessation of MARS in seven and ended lethal in four. Four complications occurred during the first, five during later (third to seventh) MARS sessions and two bleeders tolerated further sessions without complications. Coagulation parameters worsened significantly also during MARS sessions not associated with bleeding (PMARS therapy, potentially leading to bleeding complications and mortality.

Coagulation profile in open and video-assisted thoracoscopic lobectomies

DEFF Research Database (Denmark)

Christensen, Thomas Decker; Vad, Henrik; Pedersen, Søren

2018-01-01

OBJECTIVES: Lung cancer patients are perceived to have a relatively high risk of venous thromboembolic events due to an activation of the coagulation system. In terms of activation of the coagulation system, the difference between video-assisted thoracoscopic surgery (VATS) and open lobectomies...... for primary lung cancer has not been investigated. The aim of this study was to compare the impact on the coagulation system in patients undergoing curative surgery for primary lung cancer by either VATS or open lobectomies. METHODS: In total, 62 patients diagnosed with primary lung cancer were allocated...... to either VATS (n = 32) or open lobectomies (n = 30). All patients received subcutaneous injections with dalteparin (Fragmin®) 5000 IE once daily. The coagulation was assessed pre- and intraoperatively, and the first 2 days postoperatively by standard coagulation blood tests, thromboelastometry (ROTEM...

COAGULATION PROFILE IN PATIENTS PRESENTING WITH MALIGNANCIES WITH SPECIAL REFERENCES TO HEAD AND NECK EPITHELIAL CANCERS, LEUKAEMIAS AND LYMPHOMAS

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Kaberee Bhuyan

2016-04-01

Full Text Available BACKGROUND Cancer can cause activation of coagulation in many ways and there is definite evidence of abnormalities in haemostatic mechanism which is seen by the presence of one or more circulating markers of haemostatic activation & this is found to be potentiated by the release of tissue factors or procoagulants from normal tissue destructions during tumour development. OBJECTIVES • To evaluate the range of different types of haemostatic abnormalities in haematological and epithelial malignancies, especially the head and neck epithelial malignancies. • To look for the differences in the grades of these abnormalities in metastatic & non-metastatic malignancies. • To understand the prognostic value of routine tests of coagulation while predicting the outcome of the patient. • MATERIALS AND METHODS The study was conducted in the Department of Pathology, Gauhati Medical College & Hospital, Guwahati from July 2004 to June 2005. 70 cases comprising of head and neck epithelial malignancies, leukaemias and lymphomas without clinical presentation of haemorrhage or thrombosis were selected and coagulation profiles were seen. RESULTS AND OBSERVATION Out of 70 cases of both sexes & different age groups prior to therapeutic intervention, metastatic cases were 22, non-metastatic cases were 29, and 19 cases belonged to leukaemias and lymphomas. The commonest age group affected was 51–60 yrs. and male: female was 3.7: 1. The most frequent abnormality was 41 cases (58.57% of FDP positivity in the serum followed by 36 cases (51.43% of hyperfibrinogenaemia; 32 cases (45.71% shortened bleeding time, etc. DISCUSSION Activated coagulation in cancer leads to increased fibrin deposition stimulated by the destroyed tissues; increased FDPs being a strong marker of coagulation and fibrinolytic activation; increased platelet aggregation by the micro vesicles shed by tumour cells; prolonged PT & APTT being well known markers for disseminated intravascular

Anxiety and depression in patients three months after myocardial infarction: Association with markers of coagulation and the relevance of age.

Science.gov (United States)

Geiser, Franziska; Urbach, Anne Sarah; Harbrecht, Ursula; Conrad, Rupert; Pötzsch, Bernd; Amann, Nele; Kiesewetter, Katharina; Sieke, Alexandra; Wolffs, Kyra; Skowasch, Dirk

2017-08-01

Anxiety and depression are associated with an activation of coagulation and an impairment of fibrinolysis, which may contribute to the increased cardiovascular risk associated with the two disorders. However, very few studies have examined the impact of psychological distress on coagulation factors in coronary artery disease patients. The aim of this study was to assess the correlation between anxiety/depression and factors of coagulation and fibrinolysis in patients who had suffered an acute MI three months prior. In 148 patients, anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS) shortly after MI and three months later. At the second time of assessment, plasma levels of fibrinogen, factor VII, factor VIII, von Willebrand factor, prothrombin-fragment 1 and 2, tissue-plasminogen-activator, plasminogen activator inhibitor-1, D-dimer, and homocysteine were measured. In 32% of the patients, elevated levels of anxiety and depression were found three months after a MI. Multiple regression analyses showed that coagulation and fibrinolysis markers were not significantly associated with HADS anxiety and depression scores. We found that age, gender, BMI, and smoking status were significant predictors for haemostasis factors. A higher age was associated with a higher coagulability but lower anxiety levels. We measured parameters of coagulation and fibrinolysis in patients three months after MI and found no predictive value of HADS anxiety and depression scores shortly after MI or at the time of blood sampling. The effects of age on the relationship between anxiety and haemostasis should be further investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

Prothrombin time is predictive of low plasma prothrombin concentration and clinical outcome in patients with trauma hemorrhage: analyses of prospective observational cohort studies.

Science.gov (United States)

Balendran, Clare A; Lövgren, Ann; Hansson, Kenny M; Nelander, Karin; Olsson, Marita; Johansson, Karin J; Brohi, Karim; Fries, Dietmar; Berggren, Anders

2017-03-14

Fibrinogen and prothrombin have been suggested to become rate limiting in trauma associated coagulopathy. Administration of fibrinogen is now recommended, however, the importance of prothrombin to patient outcome is unknown. We have utilized two trauma patient databases (database 1 n = 358 and database 2 n = 331) to investigate the relationship of plasma prothrombin concentration on clinical outcome and coagulation status. Database 1 has been used to assess the relationship of plasma prothrombin to administered packed red blood cells (PRBC), clinical outcome and coagulation biomarkers (Prothrombin Time (PT), ROTEM EXTEM Coagulation Time (CT) and Maximum Clot Firmness (MCF)). ROC analyses have been performed to investigate the ability of admission coagulation biomarkers to predict low prothrombin concentration (database 1), massive transfusion and 24 h mortality (database 1 and 2). The importance of prothrombin was further investigated in vitro by PT and ROTEM assays in the presence of a prothrombin neutralizing monoclonal antibody and following step-wise dilution. Patients who survived the first 24 h had higher admission prothrombin levels compared to those who died (94 vs.67 IU/dL). Patients with lower transfusion requirements within the first 24 h (≤10 units of PRBCs) also had higher admission prothrombin levels compared to patients with massive transfusion demands (>10 units of PRBCs) (95 vs.62 IU/dL). Admission PT, in comparison to admission ROTEM EXTEM CT and MCF, was found to be a better predictor of prothrombin concentration <60 IU/dL (AUC 0.94 in database 1), of massive transfusion (AUC 0.92 and 0.81 in database 1 and 2 respectively) and 24 h mortality (AUC 0.90 and 0.78 in database 1 and 2, respectively). In vitro experiments supported a critical role for prothrombin in coagulation and demonstrated that PT and ROTEM EXTEM CT are sensitive methods to measure low prothrombin concentration. Our analyses suggest that prothrombin concentration

Coagulation activity in liver disease | Reza | Internet Journal of ...

African Journals Online (AJOL)

Patients with advanced hepatic failure may present with the entire spectrum of coagulation factor deficiencies. This study was designed to determine laboratory abnormalities in coagulation in chronic liver disease and the association of these abnormalities with the extent of chronic hepatitis and cirrhosis. Coagulation ...

Helical tomotherapy for SIB and hypo-fractionated treatments in lung carcinomas: A 4D Monte Carlo treatment planning study

International Nuclear Information System (INIS)

Sterpin, Edmond; Janssens, Guillaume; Orban de Xivry, Jonathan; Goossens, Samuel; Wanet, Marie; Lee, John A.; Delor, Antoine; Bol, Vanesa; Vynckier, Stefaan; Gregoire, Vincent; Geets, Xavier

2012-01-01

Purpose: To evaluate the impact of intra-fraction motion induced by regular breathing on treatment quality for helical tomotherapy treatments. Material and methods: Four patients treated by simultaneous-integrated boost (SIB) and three by hypo-fractionated stereotactic treatments (hypo-fractionated, 18 Gy/fraction) were included. All patients were coached to ensure regular breathing. For the SIB group, the tumor volume was delineated using CT information only (CTV CT ) and the boost region was based on PET information (GTV PET , no CTV extension). In the hypo-fractionated group, a GTV based on CT information was contoured. In both groups, ITVs were defined according to 4D data. The PTV included the ITV plus a setup error margin. The treatment was planned using the tomotherapy TPS on 3D CT images. In order to verify the impact of intra-fraction motion and interplay effects, dose calculations were performed using a previously validated Monte Carlo model of tomotherapy (TomoPen): first on the planning 3D CT (“planned dose”) and second, on the 10 phases of the 4D scan. For the latter, two dose distributions, termed “interplay simulated” or “no interplay” were computed with and without beamlet-phase correlation over the 10 phases and combined using deformable dose registration. Results: In all cases, DVHs of “interplay simulated” dose distributions complied within 1% of the original clinical objectives used for planning, defined according to ICRU (report 83) and RTOG (trials 0236 and 0618) recommendations, for SIB and hypo-fractionated groups, respectively. For one patient in the hypo-fractionated group, D mean to the CTV CT was 2.6% and 2.5% higher than “planned” for “interplay simulated” and “no interplay”, respectively. Conclusion: For the patients included in this study, assuming regular breathing, the results showed that interplay of breathing and tomotherapy delivery motions did not affect significantly plan delivery accuracy. Hence

Reflections on multiple strategies to reduce transfusion in cancer patients: A joint narrative.

Science.gov (United States)

Goubran, Hadi; Seghatchian, Jerard; Prokopchuk-Gauk, Oksana; Radosevic, Julia; Sabry, Waleed; Iqbal, Nayyer; Burnouf, Thierry

2017-06-01

Transfusion of red blood cells, platelets and plasma is widely used in the management of anemia and coagulopathy in cancer patients undergoing surgery, chemotherapy, and radiation. The decision to transfuse should not be made lightly as exposure to transfused blood, whether from an allogeneic or even autologous source, is not without risk and the long-term effect of blood transfusion on cancer outcomes remains questionable. Recognition of anemia associated with nutritional deficiency should be promptly corrected while avoiding the use of erythropoiesis stimulating agents. Minimizing blood loss and the prompt control of bleeding, coupled with a restrictive transfusion strategy, seem to be a reasonable approach that does not appear to be associated with long-term sequelae. Limiting platelet transfusion to patients with severe hypo-proliferative thrombocytopenia, and implementation of local hemostatic measures, together with the use of fractionated coagulation factor concentrates, as an alternative to frozen plasma transfusion, may reduce the exposure of cancer patients to potentially harmful thrombogenic and pro-inflammatory cellular microparticles. This joint narrative highlights current opinions for minimizing blood usage in patients with cancer. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

Coagulation competence for predicting perioperative hemorrhage in patients treated with lactated Ringer's vs. Dextran

DEFF Research Database (Denmark)

Rasmussen, Kirsten C; Højskov, Michael; Johansson, Per Ingemar

2015-01-01

to receive either lactated Ringer's solution or Dextran 70 (Macrodex ®) that affects coagulation competence. RESULTS: By thrombelastography evaluated coagulation competence, Dextran 70 reduced "maximal amplitude" (MA) by 25 % versus a 1 % reduction with the administration of lactated Ringer's solution (P ....001). Blinded evaluation of the blood loss was similar in the two groups of patients - 2339 ml with the use of Dextran 70 and 1822 ml in the lactated Ringer's group (P = 0.27). Yet, the blood loss was related to the reduction in MA (r = -0.427, P = 0.008) and by multiple regression analysis independently...... associated with MA (P = 0.01). Thus, 11 patients in the dextran group (58 %) developed a clinical significant blood loss (>1500 ml) compared to only four patients (22 %) in the lactated Ringer's group (P = 0.04). CONCLUSIONS: With the use of Dextran 70 vs. lactated Ringer's solution during cystectomy...

Infrared coagulation: a new treatment for hemorrhoids

International Nuclear Information System (INIS)

Leicester, R.J.; Nicholls, R.J.; Mann, C.V.

1981-01-01

Many methods, which have effectively reduced the number of patients requiring hospital admission, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neiger et al. described a new method that used infrared coagulation, which produced minimal side effects. The authors have conducted a prospective, randomized trial to evaluate infrared coagulation compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection sclerotherapy in treating non-prolapsing hemorrhoids and that it compares favorably with rubber band ligation in most prolapsing hemorrhoids. No complications occurred, and significantly fewer patients experienced pain after infrared coagulation

Treatment outcome of localized prostate cancer by 70 Gy hypofractionated intensity-modulated radiotherapy with a customized rectal balloon

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyun Jung; Kim, Jun Won; Hong, Sung Joon; Rha, Koon Ho; Lee, Chang Geol; Yang, Seung Choul; Choi, Young Deuk; Suh, Chang Ok; Cho, Jae Ho [Yonsei Cancer Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

2014-09-15

We aimed to analyze the treatment outcome and long-term toxicity of 70 Gy hypofractionated intensity-modulated radiotherapy (IMRT) for localized prostate cancer using a customized rectal balloon. We reviewed medical records of 86 prostate cancer patients who received curative radiotherapy between January 2004 and December 2011 at our institution. Patients were designated as low (12.8%), intermediate (20.9%), or high risk (66.3%). Thirty patients received a total dose of 70 Gy in 28 fractions over 5 weeks via IMRT (the Hypo-IMRT group); 56 received 70.2 Gy in 39 fractions over 7 weeks via 3-dimensional conformal radiotherapy (the CF-3DRT group, which served as a reference for comparison). A customized rectal balloon was placed in Hypo-IMRT group throughout the entire radiotherapy course. Androgen deprivation therapy was administered to 47 patients (Hypo-IMRT group, 17; CF-3DRT group, 30). Late genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated according to the Radiation Therapy Oncology Group criteria. The median follow-up period was 74.4 months (range, 18.8 to 125.9 months). The 5-year actuarial biochemical relapse-free survival rates for low-, intermediate-, and high-risk patients were 100%, 100%, and 88.5%, respectively, for the Hypo-IMRT group and 80%, 77.8%, and 63.6%, respectively, for the CF-3DRT group (p < 0.046). No patient presented with acute or late GU toxicity > or =grade 3. Late grade 3 GI toxicity occurred in 2 patients (3.6%) in the CF-3DRT group and 1 patient (3.3%) in the Hypo-IMRT group. Hypo-IMRT with a customized rectal balloon resulted in excellent biochemical control rates with minimal toxicity in localized prostate cancer patients.

Coagulation Profile as a Risk Factor for 30-day Morbidity Following Cervical Laminectomy and Fusion.

Science.gov (United States)

Bronheim, Rachel S; Oermann, Eric K; Cho, Samuel K; Caridi, John M

2018-02-15

Retrospective analysis of prospectively collected data. The aim of this study was to determine the ability of abnormal coagulation profile to predict adverse events following posterior cervical laminectomy and fusion (PCLF). PCLF is an increasingly common procedure used to treat a variety of traumatic and degenerative spinal conditions. Abnormal coagulation profile is associated with postoperative adverse events, including blood transfusion. There is a paucity of literature that specifically addresses the relationship between coagulation profile and complications following PCLF. ACS-NSQIP was utilized to identify patients undergoing PCLF between 2006 and 2013. A total of 3546 patients met inclusion criteria. Multivariate analysis was utilized to identify associations between abnormal coagulation profile and postoperative complications. Membership in the low-platelet cohort was an independent risk factor for myocardial infarction (Odds Ratio (OR) = 5.4 [1.0, 29.1], P = 0.049) and bleeding transfusion (OR = 2.0 [1.2, 3.4], P = 0.011). Membership in the high international normalized ratio group was an independent risk factor for pneumonia (OR = 6.3 [2.5, 16.1], P 48 hours (OR = 6.5 [2.3, 18.4], P 48 hours (OR = 4.8 [1.9, 12.4], P = 0.001), cerebrovascular accident/stroke with neurological deficit (OR = 24.8 [2.9, 210.6], P = 0.003), bleeding transfusion (OR = 2.1 [1.1, 4.1], P = 0.032), reoperation (OR = 3.6 [1.4, 9.3], P = 0.008), and sepsis (OR = 3.4 [1.1, 10.4], P = 0.031). This is the first large study to document abnormal coagulation profile as an independent predictor of outcomes following PCLF. Abnormal coagulation profile represents a predictor of complications that can be medically mitigated, and is therefore a valuable parameter to assess preoperatively. Coagulation profile should continue to play a role in targeting patients for risk stratification, preoperative optimization, and

Effect of the hypo iodic diet in thyroid uptake. Its utility for 131I applications in differentiated thyroid carcinomas

International Nuclear Information System (INIS)

Brisoli, Jorge; Perinetti, Hector; Borremans, Carlos; Notti, Alberto

2005-01-01

Full text: To evaluate and to quantify the real profit of a hypo iodic diet before using a 131 I in DTC, are analyzed the values obtained in 213 patients in whom 364 controls were done with uptake tests before given the control, ablative and therapeutic 131 I doses. The patients were discriminated in 8 groups according as if they were treated with surgery, surgery and ablative or therapeutic 131 I, if surgery was realized by specialist or general surgeon. It also was considered if they had done or not the hypo iodic diet before the control. In those patients that were operated and checked by specialists in thyroid pathologies, it was verified a moderate increase in the uptake values (a little but more than 20% in patients that had done a previous diet). In the thyroidectomized group the average uptake in 88 patients with diet was 10.3%, and in 27 patients without diet 8.0%, with a difference of more than 22% in the formers. In patients with surgery that received complementary 131 I, the average uptake in 95 measurements was 1.1% with previous diet, and 0.8% in 11 patients that did not accomplish the diet, with a difference of 21% more uptake when hypo iodic diet was done. The results in patients with surgeries performed by a general surgeon (143 controls) were uncertain and in some cases illogical. These results are related with the surgery magnitude. Conclusion: The hypo iodic diet moderately increases (around more than 20%) the uptake values of the remnant tissue, postsurgery. The increase is proportional to the amount of tissue. The previous diet is considered necessary before an ablative, therapeutic dose, or in those cases that for clinical or complementary evidences (i.e: thyroglobulin) are supposed to be carriers of significant amounts of thyroid tissue. Because of the relative bother and the minimal difference found in patients well ablationed, it would not be necessary in those patients with low uptake in previous controls. Without having it as a goal

Long-term outcomes of patients receiving a massive transfusion after trauma.

Science.gov (United States)

Mitra, Biswadev; Gabbe, Belinda J; Kaukonen, Kirsi-Maija; Olaussen, Alexander; Cooper, David J; Cameron, Peter A

2014-10-01

Resuscitation of patients presenting with hemorrhagic shock after major trauma has evolved to incorporate multiple strategies to maintain tissue perfusion and oxygenation while managing coagulation disorders. We aimed to study changes across time in long-term outcomes in patients with major trauma. A retrospective observational study in a single major trauma center in Australia was conducted. We included all patients with major trauma and massive blood transfusion within the first 24 h during a 6-year period (from 2006 to 2011). The main outcome measures were Glasgow Outcome Score-Extended (GOSE) and work capacity at 6 and 12 months. There were 5,915 patients with major trauma of which 365 (6.2%; 95% confidence interval [95% CI], 5.6 - 6.8) received a massive transfusion. The proportion of major trauma patients receiving a massive transfusion decreased across time from 8.2% to 4.4% (P GOSE at 6 months, and 44% unfavorable GOSE at 12 months. Massive transfusion was independently associated with unfavorable outcomes at 6 months after injury (adjusted odds ratio, 1.56; 95% CI, 1.05 - 2.31) but not at 12 months (adjusted odds ratio, 0.85; 95% CI, 0.72 - 1.01). A significant reduction in massive transfusion rates was observed. Unfavorable long-term outcomes among patients receiving a massive transfusion after trauma were frequent with a substantial proportion of survivors experiencing poor functional status 1 year after injury.

In vitro investigation of the effects of exogenous sugammadex on coagulation in orthopedic surgical patients.

Science.gov (United States)

Lee, Il Ok; Kim, Young Sung; Chang, Hae Wone; Kim, Heezoo; Lim, Byung Gun; Lee, Mido

2018-05-24

Previous studies have shown that sugammadex resulted in the prolongation of prothrombin time and activated partial thromboplastin time. In this study, we aimed to investigate the in vitro effects of exogenous sugammadex on the coagulation variables of whole blood in healthy patients who underwent orthopedic surgery. The effects of sugammadex on coagulations were assessed using thromboelastography (TEG) in kaolin-activated citrated blood samples taken from 14 healthy patients who underwent orthopedic surgery. The in vitro effects of three different concentrations of sugammadex (42, 193, and 301 μg mL - 1 ) on the TEG profiles were compared with those of the control (0 μg mL - 1 ). Previous studies indicated that these exogenous concentrations correspond to the approximate maximum plasma concentrations achieved after the administration of 4, 16, and 32 mg kg - 1 sugammadex to healthy subjects. Increased sugammadex concentrations were significantly associated with reduced coagulation, as evidenced by increases in reaction time (r), coagulation time, and time to maximum rate of thrombus generation (TMRTG), and decreases in the angle, maximum amplitude, and maximum rate of thrombus generation. Compared with the control, the median percentage change (interquartile range) in the TEG values of the samples treated with the highest exogenous sugammadex concentration was the greatest for r, 53% (26, 67.3%), and TMRTG, 48% (26, 59%). This in vitro study suggests that supratherapeutic doses of exogenous sugammadex might be associated with moderate hypocoagulation in the whole blood of healthy subjects. identifier:  UMIN000029081 , registered 11 September 2017.

Bladder perforation owing to a unipolar coagulating device.

Science.gov (United States)

Pakter, J; Budnick, L D

1981-09-15

A report on a patient who sustained a burn and perforation of the urinary bladder from visible sparks emanating from a unipolar coagulating device during the couse of laparoscopic sterilization is presented. It is the first report of urinary bladder burns using a unipolar coagulating device. A 24-year-old woman, gravida 10, para 3, abortus 7, underwent a laparoscopic sterilization with a unipolar coagulating device. As the physician was finishing the coagulation, a spark from the device caused a 1-2 cm burn with a central area of perforation into the urinary bladder. Conservative treatment was recommended, and consisted of Foley catheterization and drainage for 5 days. Initial urine culture revealed Klebsiella species, and oral ampicillin was prescribed. Hematuria was noted throughout the patient's hospitalization, and blood clots were present in the urine on Day 2 postoperation. The patient had no abdominal or flank pain, was afebrile, and had a stable hemoglobin level during the hospital stay. Cystography was performed on Day 5 postoperatively and demonstrated no perforation. Foley catheter was removed. Patient was discharged 2 days later and remains in good health 3 months postoperatively.

41 CFR 109-27.5107 - Recovery of silver from used hypo solution and scrap film.

Science.gov (United States)

2010-07-01

... used hypo solution and scrap film. 109-27.5107 Section 109-27.5107 Public Contracts and Property... § 109-27.5107 Recovery of silver from used hypo solution and scrap film. The requirements for the recovery of silver from used hypo solution and scrap film are contained in § 109-45.1003 of this chapter. ...

SU-E-T-776: Use of Quality Metrics for a New Hypo-Fractionated Pre-Surgical Mesothelioma Protocol

International Nuclear Information System (INIS)

Richardson, S; Mehta, V

2015-01-01

Purpose: The “SMART” (Surgery for Mesothelioma After Radiation Therapy) approach involves hypo-fractionated radiotherapy of the lung pleura to 25Gy over 5 days followed by surgical resection within 7. Early clinical results suggest that this approach is very promising, but also logistically challenging due to the multidisciplinary involvement. Due to the compressed schedule, high dose, and shortened planning time, the delivery of the planned doses were monitored for safety with quality metric software. Methods: Hypo-fractionated IMRT treatment plans were developed for all patients and exported to Quality Reports™ software. Plan quality metrics or PQMs™ were created to calculate an objective scoring function for each plan. This allows for an objective assessment of the quality of the plan and a benchmark for plan improvement for subsequent patients. The priorities of various components were incorporated based on similar hypo-fractionated protocols such as lung SBRT treatments. Results: Five patients have been treated at our institution using this approach. The plans were developed, QA performed, and ready within 5 days of simulation. Plan Quality metrics utilized in scoring included doses to OAR and target coverage. All patients tolerated treatment well and proceeded to surgery as scheduled. Reported toxicity included grade 1 nausea (n=1), grade 1 esophagitis (n=1), grade 2 fatigue (n=3). One patient had recurrent fluid accumulation following surgery. No patients experienced any pulmonary toxicity prior to surgery. Conclusion: An accelerated course of pre-operative high dose radiation for mesothelioma is an innovative and promising new protocol. Without historical data, one must proceed cautiously and monitor the data carefully. The development of quality metrics and scoring functions for these treatments allows us to benchmark our plans and monitor improvement. If subsequent toxicities occur, these will be easy to investigate and incorporate into the

SU-E-T-776: Use of Quality Metrics for a New Hypo-Fractionated Pre-Surgical Mesothelioma Protocol

Energy Technology Data Exchange (ETDEWEB)

Richardson, S; Mehta, V [Swedish Cancer Institute, Seattle, WA (United States)

2015-06-15

Purpose: The “SMART” (Surgery for Mesothelioma After Radiation Therapy) approach involves hypo-fractionated radiotherapy of the lung pleura to 25Gy over 5 days followed by surgical resection within 7. Early clinical results suggest that this approach is very promising, but also logistically challenging due to the multidisciplinary involvement. Due to the compressed schedule, high dose, and shortened planning time, the delivery of the planned doses were monitored for safety with quality metric software. Methods: Hypo-fractionated IMRT treatment plans were developed for all patients and exported to Quality Reports™ software. Plan quality metrics or PQMs™ were created to calculate an objective scoring function for each plan. This allows for an objective assessment of the quality of the plan and a benchmark for plan improvement for subsequent patients. The priorities of various components were incorporated based on similar hypo-fractionated protocols such as lung SBRT treatments. Results: Five patients have been treated at our institution using this approach. The plans were developed, QA performed, and ready within 5 days of simulation. Plan Quality metrics utilized in scoring included doses to OAR and target coverage. All patients tolerated treatment well and proceeded to surgery as scheduled. Reported toxicity included grade 1 nausea (n=1), grade 1 esophagitis (n=1), grade 2 fatigue (n=3). One patient had recurrent fluid accumulation following surgery. No patients experienced any pulmonary toxicity prior to surgery. Conclusion: An accelerated course of pre-operative high dose radiation for mesothelioma is an innovative and promising new protocol. Without historical data, one must proceed cautiously and monitor the data carefully. The development of quality metrics and scoring functions for these treatments allows us to benchmark our plans and monitor improvement. If subsequent toxicities occur, these will be easy to investigate and incorporate into the

The rate of hypo-osmotic challenge influences regulatory volume decrease (RVD) and mechanical properties of articular chondrocytes.

Science.gov (United States)

Wang, Z; Irianto, J; Kazun, S; Wang, W; Knight, M M

2015-02-01

Osteoarthritis (OA) is associated with a gradual reduction in the interstitial osmotic pressure within articular cartilage. The aim of this study was to compare the effects of sudden and gradual hypo-osmotic challenge on chondrocyte morphology and biomechanics. Bovine articular chondrocytes were exposed to a reduction in extracellular osmolality from 327 to 153 mOsmol/kg applied either suddenly (osmotic stress, 66% of chondrocytes exhibited an increase in diameter followed by RVD, whilst 25% showed no RVD. By contrast, cells exposed to gradual hypo-osmotic stress exhibited reduced cell swelling without subsequent RVD. There was an increase in the equilibrium modulus for cells exposed to sudden hypo-osmotic stress. However, gradual hypo-osmotic challenge had no effect on cell mechanical properties. This cell stiffening response to sudden hypo-osmotic challenge was abolished when actin organization was disrupted with cytochalasin D or RVD inhibited with REV5901. Both sudden and gradual hypo-osmotic challenge reduced cortical F-actin distribution and caused chromatin decondensation. Sudden hypo-osmotic challenge increases chondrocyte mechanics by activation of RVD and interaction with the actin cytoskeleton. Moreover, the rate of hypo-osmotic challenge is shown to have a profound effect on chondrocyte morphology and biomechanics. This important phenomenon needs to be considered when studying the response of chondrocytes to pathological hypo-osmotic stress. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Changes of coagulation and fibrinolysis in middle-old aged patients with nonvalvular atrial fibrillation

International Nuclear Information System (INIS)

Li Xi; Xie Ying; Zhang Weijun; Zhao Ruixiang; Peng Xinjie; Zhang Wen; Zhang Yan; Cheng Xiuqin; Wang Longhua; Guo Yonghe; Zhou Yujie; Wen Shaojun; Liu Jielin

2008-01-01

Objective: To evaluate the changes of coagulation and fibrinolysis function in the middle-old aged patients with nonvalvular atrial fibrillation. Methods: The levels of D-Dimer and tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) were detected in 92 middle-aged patients with nonvalvular atrial fibrillation (AF group) and 60 patients with sinus rhythm (control group) by immune turbidimetry and enzyme linked immunoadsorbent assay (ELISA). Univariate analysis was used to determine the differences between two groups, and covariance analysis was used to determine the factors which might affect coagulation and fibrinolysis indexes. Results: 1)The plasma levels of D-Dimer [(0.16±0.10) mg·L -1 ] and t-PA [(42.58± 30.28) μg·L -1 ] and PAI-1 [(86.03 ± 21.43) μg·L -1 ] in AF group were significantly higher than those in the control group [(0.10 ± 0.08) mg·L -1 , (26.02±13.84) μg·L -1 , (64.94±24.35) μg·L -1 ] (P<0.05 or P <0.001). The ratio of PAI-1/t-PA in AF group was higher than that in control group slightly. 2) After adjustment of the factors which included sex, age and plasma creatinine, uric acid, blood sugar, triglyceride and cholesterol, the levels of D-Dimer (P=0.047), t-PA (P=0.264) and PAI-1 (P=0.001) in AF group were higher than those in the control group. Conclusion: The middle-old aged patients with nonvalvular atrial fibrillation lose their balance of coagulation and fibrinolysis in the state of hypercoagulated and hypofibrinolysis. (authors)

Marketingová komunikace Hypo stavební spořitelny 2007/2008

OpenAIRE

Kratochvíl, Viktor

2010-01-01

Diploma thesis " Marketing communication of HYPO building savings bank 2007/2008 " deals with the activities of marketing communication of HYPO building savings bank between March 2007 and March 2008. The purpose of this thesis is to describe individual activities of marketing communication of this subject and to analyze goals of its marketing communication. The thesis evaluates the impact of the communication strategy on the public's perception of the subject.

Ketoprofen and antinociception in hypo-oestrogenic Wistar rats fed on a high sucrose diet.

Science.gov (United States)

Jaramillo-Morales, Osmar Antonio; Espinosa-Juárez, Josué Vidal; García-Martínez, Betzabeth Anali; López-Muñoz, Francisco Javier

2016-10-05

Non-steroidal anti-inflammatory drugs such as ketoprofen are the most commonly used analgesics for the treatment of pain. However, no studies have evaluated the analgesic response to ketoprofen in conditions of obesity. The aim of this study was to analyse the time course of nociceptive pain in Wistar rats with and without hypo-oestrogenism on a high sucrose diet and to compare the antinociceptive response using ketoprofen. Hypo-oestrogenic and naïve rats received a hyper caloric diet (30% sucrose) or water ad libitum for 17 weeks, the thermal nociception ("plantar test" method) and body weight were tested during this period. A biphasic response was observed: thermal latency decreased in the 4th week (hyperalgesia), while from 12th to 17th week, thermal latency increased (hypoalgesia) in hypo-oestrogenic rats fed with high sucrose diet compared with the hypo-oestrogenic control group. At 4th and 17th weeks, different doses of ketoprofen (1.8-100mg/kg p.o.), were evaluated in all groups. The administration of ketoprofen at 4th and 17th weeks showed dose-dependent effects in the all groups; however, a greater pharmacological efficacy was observed in the 4th week in the hypo-oestrogenic animals that received sucrose. Nevertheless, in all the groups significantly diminish the antinociceptive effects in the 17th week. Our data showed that nociception was altered in the hypo-oestrogenic animals that were fed sucrose (hyperalgesia and hypoalgesia). Ketoprofen showed a dose-dependent antinociceptive effect at both time points. However, hypo-oestrogenism plus high-sucrose diet modifies the antinociceptive effect of ketoprofen. Copyright © 2016 Elsevier B.V. All rights reserved.

STUDY OF CHANGES IN COAGULATION PROFILE OF PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY USING CARBON DIOXIDE PNEUMOPERITONEUM

Directory of Open Access Journals (Sweden)

Vasuki Rajam

2017-04-01

Full Text Available BACKGROUND Laparoscopic cholecystectomy is now the gold standard procedure and with over 5,00,000 procedures being done annually, laparoscopic cholecystectomy assumes a great significance in general surgical specialty. This study aims to study the effects of carbon dioxide pneumoperitoneum on the coagulation system of patients undergoing laparoscopic cholecystectomy and make the surgeon aware of the detrimental effects. MATERIALS AND METHODS A prospective clinical observational study of 50 patients selected by systematic sampling method from January 2015 to September 2015 at our institution was conducted to determine the results of changes in coagulation profile of patients undergoing laparoscopic cholecystectomy using carbon dioxide pneumoperitoneum. RESULTS The mean prothrombin time of the patients before surgery is 11.83 seconds. The standard deviation was 1.008 and standard error of mean was 0.143. The mean of prothrombin time 6 hours after surgery was 11.7 seconds. The standard deviation was 0.898 and the standard error of mean being 0.127. The difference in the mean between the two groups was 0.130. The p-value was 0.0109 (<0.05. Hence, the value was statistically extremely significant. The values for D-dimer were analysed. The mean value of D-dimer before surgery is 129.78. The standard deviation was 21.01 and standard error of mean was at 2.97. In the D-dimer values after surgery, mean was calculated to be 350.22 with the standard deviation at 73.21 and standard error of mean at 10.35. CONCLUSION Our study concluded that there is activation of both coagulation and fibrinolytic systems post laparoscopic cholecystectomy.

Blood coagulation abnormalities in multibacillary leprosy patients.

Science.gov (United States)

Silva, Débora Santos da; Teixeira, Lisandra Antonia Castro; Beghini, Daniela Gois; Ferreira, André Teixeira da Silva; Pinho, Márcia de Berredo Moreira; Rosa, Patricia Sammarco; Ribeiro, Marli Rambaldi; Freire, Monica Di Calafiori; Hacker, Mariana Andrea; Nery, José Augusto da Costa; Pessolani, Maria Cristina Vidal; Tovar, Ana Maria Freire; Sarno, Euzenir Nunes; Perales, Jonas; Bozza, Fernando Augusto; Esquenazi, Danuza; Monteiro, Robson Queiroz; Lara, Flavio Alves

2018-03-01

Leprosy is a chronic dermato-neurological disease caused by Mycobacterium leprae infection. In 2016, more than 200,000 new cases of leprosy were detected around the world, representing the most frequent cause of infectious irreversible deformities and disabilities. In the present work, we demonstrate a consistent procoagulant profile on 40 reactional and non-reactional multibacillary leprosy patients. A retrospective analysis in search of signs of coagulation abnormalities among 638 leprosy patients identified 35 leprosy patients (5.48%) which displayed a characteristic lipid-like clot formed between blood clot and serum during serum harvesting, herein named 'leprosum clot'. Most of these patients (n = 16, 45.7%) belonged to the lepromatous leprosy pole of the disease. In addition, formation of the leprosum clot was directly correlated with increased plasma levels of soluble tissue factor and von Willebrand factor. High performance thin layer chromatography demonstrated a high content of neutral lipids in the leprosum clot, and proteomic analysis demonstrated that the leprosum clot presented in these patients is highly enriched in fibrin. Remarkably, differential 2D-proteomics analysis between leprosum clots and control clots identified two proteins present only in leprosy patients clots: complement component 3 and 4 and inter-alpha-trypsin inhibitor family heavy chain-related protein (IHRP). In agreement with those observations we demonstrated that M. leprae induces hepatocytes release of IHRP in vitro. We demonstrated that leprosy MB patients develop a procoagulant status due to high levels of plasmatic fibrinogen, anti-cardiolipin antibodies, von Willebrand factor and soluble tissue factor. We propose that some of these components, fibrinogen for example, presents potential as predictive biomarkers of leprosy reactions, generating tools for earlier diagnosis and treatment of these events.

Hypo-egoic self-regulation: exercising self-control by diminishing the influence of the self.

Science.gov (United States)

Leary, Mark R; Adams, Claire E; Tate, Eleanor B

2006-12-01

Theory and research dealing with self-regulation have focused primarily on instances of self-regulation that involve high levels of self-reflection and effortful self-control. However, intentionally trying to control one's behavior sometimes reduces the likelihood of achieving one's goals. This article examines the process of hypo-egoic self-regulation in which people relinquish deliberate, conscious control over their own behavior so that they will respond more naturally, spontaneously, or automatically. An examination of spontaneously occurring hypo-egoic states (such as flow, deindividuation, and transcendence) suggests that hypo-egoic states are characterized by lowered self-awareness and/or an increase in concrete and present-focused self-thoughts. In light of this, people may intentionally foster hypo-egoism via two pathways-(a) taking steps to reduce the proportion of time that they are self-aware (such as repeating a behavior until it is automatic or practicing meditation) or (b) increasing the concreteness of their self-thoughts (such as inducing a concrete mindset or practicing mindfulness). In this way, people may deliberately choose to regulate hypo-egoically when effortful control might be detrimental to their performance.

High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.

Science.gov (United States)

Al Shafouri, N; Narvey, M; Srinivasan, G; Vallance, J; Hansen, G

2015-01-01

In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to -0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

Characterization of homeostasis and erythron and their correlation with both immune and metabolic indices at liquidators of the Chernobyl accident

International Nuclear Information System (INIS)

Flyunt, I.S.

2001-01-01

Patients with urolithiasis and calculus pyelonephritis who are liquidators of the accident at the Chernobyl nuclear power plant have disturbances of homeostasis as disseminated intravascular coagulation and of erythron as hyperchrome macrocytic hypo regenerative anemia that are correlated with certain immune and metabolic changes

Blood coagulation abnormalities in multibacillary leprosy patients.

Directory of Open Access Journals (Sweden)

Débora Santos da Silva

2018-03-01

Full Text Available Leprosy is a chronic dermato-neurological disease caused by Mycobacterium leprae infection. In 2016, more than 200,000 new cases of leprosy were detected around the world, representing the most frequent cause of infectious irreversible deformities and disabilities.In the present work, we demonstrate a consistent procoagulant profile on 40 reactional and non-reactional multibacillary leprosy patients. A retrospective analysis in search of signs of coagulation abnormalities among 638 leprosy patients identified 35 leprosy patients (5.48% which displayed a characteristic lipid-like clot formed between blood clot and serum during serum harvesting, herein named 'leprosum clot'. Most of these patients (n = 16, 45.7% belonged to the lepromatous leprosy pole of the disease. In addition, formation of the leprosum clot was directly correlated with increased plasma levels of soluble tissue factor and von Willebrand factor. High performance thin layer chromatography demonstrated a high content of neutral lipids in the leprosum clot, and proteomic analysis demonstrated that the leprosum clot presented in these patients is highly enriched in fibrin. Remarkably, differential 2D-proteomics analysis between leprosum clots and control clots identified two proteins present only in leprosy patients clots: complement component 3 and 4 and inter-alpha-trypsin inhibitor family heavy chain-related protein (IHRP. In agreement with those observations we demonstrated that M. leprae induces hepatocytes release of IHRP in vitro.We demonstrated that leprosy MB patients develop a procoagulant status due to high levels of plasmatic fibrinogen, anti-cardiolipin antibodies, von Willebrand factor and soluble tissue factor. We propose that some of these components, fibrinogen for example, presents potential as predictive biomarkers of leprosy reactions, generating tools for earlier diagnosis and treatment of these events.

Changes of plasma IL-6 and TNF-α levels during peri-operative period in patients undergoing laser photo-coagulation of greater saphenous varicosities

International Nuclear Information System (INIS)

Wang Taihan; Wang Chunxi

2005-01-01

Objective: To investigate the plasma levels of IL-6 and TNF-α during peri-operative period in patients undergoing laser photocoagulation of greater saphenous varicosities. Methods: Plasma IL-6 and TNF-α levels were determined with RIA before operation and 1, 3, 7, 14 days post-operatively in 110 patients with greater saphenous vein varicosity undergoing different forms of treatment (intravascular laser photo-coagulation 43, photo-coagulation combined with venous valve repair 35, high ligation and segmental stripping 32). Skin trophic disturbances were present in 56 of the 110 patients. Plasma IL-6 and TNF-α levels were also measured in 33 controls. Results: The plasma IL-6 and TNF-α levels in patients with skin trophic disturbances were significantly higher than those in controls (P<0.01), while levels in patients without skin lesions were not much changed. The plasma IL-6 and TNF-α levels were increased at first and dropped later to approaching pre-operative value by d14 in all the 110 patients after operation, however, the amount of increase was least and the normalization was also soonest in the simple photo-coagulation group, the reverse was true for the conventional operation group. Conclusion: Laser photo-coagulation is least stressful among the three types of operation and magnitude of changes of plasma IL-6 and TNF-α levels correctly reflects the intensity of stress. (authors)

Luteal activity of pregnant rats with hypo-and hyperthyroidism.

Science.gov (United States)

Silva, Juneo Freitas; Ocarino, Natália Melo; Serakides, Rogéria

2014-07-12

Luteal activity is dependent on the interaction of various growth factors, cytokines and hormones, including the thyroid hormones, being that hypo- and hyperthyroidism alter the gestational period and are also a cause of miscarriage and stillbirth. Because of that, we evaluated the proliferation, apoptosis and expression of angiogenic factors and COX-2 in the corpus luteum of hypo- and hyperthyroid pregnant rats. Seventy-two adult female rats were equally distributed into three groups: hypothyroid, hyperthyroid and control. Hypo- and hyperthyroidism were induced by the daily administration of propylthiouracil and L-thyroxine, respectively. The administration began five days before becoming pregnant and the animals were sacrificed at days 10, 14, and 19 of gestation. We performed an immunohistochemical analysis to evaluate the expression of CDC-47, VEGF, Flk-1 (VEGF receptor) and COX-2. Apoptosis was evaluated by the TUNEL assay. We assessed the gene expression of VEGF, Flk-1, caspase 3, COX-2 and PGF2α receptor using real time RT-PCR. The data were analyzed by SNK test. Hypothyroidism reduced COX-2 expression on day 10 and 19 (P Hyperthyroidism increased the expression of COX-2 on day 19 (P hyperthyroid animals, being this effect dependent of the gestational period.

Investigation of coagulation activity of natural coagulants from seeds of different leguminose species

Directory of Open Access Journals (Sweden)

Šćiban Marina B.

2005-01-01

Full Text Available The ability of seeds of plants: Phaseolus vulgaris, Robinia pseudoacacia Ceratonia siliqua and Amorpha fruticosa, to act as natural coagulants was tested using synthetic turbid water. This water was prepared by adding kaolin into tap water, just before the test. Active components were extracted from ground seeds with distilled water. The coagulation ability of this extract was assessed by the use of standard jar test measurements in water with various initial turbidity. Investigation of these natural coagulants was confirmed their positive coagulation activity. Of all plants that have been examined, the seed extract from Ceratonia siliqua appeared to be one of the most effective coagulants for water treatment. A dose of 20 mg/l of this coagulant resulted in 100% coagulation activity for clarification of water with 17.5 NTU initial turbidity.

Coagulation parameters and platelet function analysis in patients with acromegaly.

Science.gov (United States)

Colak, A; Yılmaz, H; Temel, Y; Demirpence, M; Simsek, N; Karademirci, İ; Bozkurt, U; Yasar, E

2016-01-01

Acromegaly is associated with increased cardiovascular morbidity and mortality. The data about the evaluation of coagulation and fibrinolysis in acromegalic patients are very limited and to our knowledge, platelet function analysis has never been investigated. So, we aimed to investigate the levels of protein C, protein S, fibrinogen, antithrombin 3 and platelet function analysis in patients with acromegaly. Thirty-nine patients with active acromegaly and 35 healthy subjects were included in the study. Plasma glucose and lipid profile, fibrinogen levels, GH and IGF-1 levels and protein C, protein S and antithrombin III activities were measured in all study subjects. Also, platelet function analysis was evaluated with collagen/ADP and collagen-epinephrine-closure times. Demographic characteristics of the patient and the control were similar. As expected, fasting blood glucose levels and serum GH and IGF-1 levels were significantly higher in the patient group compared with the control group (pglc: 0.002, pGH: 0.006, pIGF-1: 0.001, respectively). But lipid parameters were similar between the two groups. While serum fibrinogen and antithrombin III levels were found to be significantly higher in acromegaly group (p fibrinogen: 0.005 and pantithrombin III: 0.001), protein S and protein C activity values were significantly lower in the patient group (p protein S: 0.001, p protein C: 0.001). Also significantly enhanced platelet function (measured by collagen/ADP- and collagen/epinephrine-closure times) was demonstrated in acromegaly (p col-ADP: 0.002, p col-epinephrine: 0.002). The results did not change, when we excluded six patients with type 2 diabetes in the acromegaly group. There was a negative correlation between serum GH levels and protein S (r: -0.25, p: 0.04)) and protein C (r: -0.26, p: 0.04) values. Likewise, there was a negative correlation between IGF-1 levels and protein C values (r: -0.39, p: 0.002), protein S values (r: -0.39, p: 0.001), collagen

Physiological levels of blood coagulation factors IX and X control coagulation kinetics in an in vitro model of circulating tissue factor

International Nuclear Information System (INIS)

Tormoen, Garth W; Khader, Ayesha; Gruber, András; McCarty, Owen J T

2013-01-01

Thrombosis significantly contributes to cancer morbidity and mortality. The mechanism behind thrombosis in cancer may be circulating tissue factor (TF), as levels of circulating TF are associated with thrombosis. However, circulating TF antigen level alone has failed to predict thrombosis in patients with cancer. We hypothesize that coagulation factor levels regulate the kinetics of circulating TF-induced thrombosis. Coagulation kinetics were measured as a function of individual coagulation factor levels and TF particle concentration. Clotting times increased when pooled plasma was mixed at or above a ratio of 4:6 with PBS. Clotting times increased when pooled plasma was mixed at or above a ratio of 8:2 with factor VII-depleted plasma, 7:3 with factor IX- or factor X-depleted plasmas, or 2:8 with factor II-, V- or VIII-depleted plasmas. Addition of coagulation factors VII, X, IX, V and II to depleted plasmas shortened clotting and enzyme initiation times, and increased enzyme generation rates in a concentration-dependent manner. Only additions of factors IX and X from low-normal to high-normal levels shortened clotting times and increased enzyme generation rates. Our results demonstrate that coagulation kinetics for TF particles are controlled by factor IX and X levels within the normal physiological range. We hypothesize that individual patient factor IX and X levels may be prognostic for susceptibility to circulating TF-induced thrombosis. (paper)

PTH(1-84) Replacement Therapy in Hypoparathyroidism (HypoPT): a Randomized Controlled Trial on Pharmacokinetics and Dynamic effects Following 24 Weeks of treatment

DEFF Research Database (Denmark)

Sikjær, Tanja Tvistholm; Amstrup, Anne Kristine; Rolighed, Lars

In HypoPT, lack of PTH necessitates treatment with calcium and vitamin D analogues in order to avoid hypocalcemia. To study if replacement with the missing hormone possesses advantages, we randomized 62 patients with HypoPT to 24-wks with a daily SC injection in the thigh of PTH(1-84) 100 μg...... or similar placebo, as add to conventional therapy. At end of study, we performed a 24h biochemical monitoring on 39 patients (22 on PTH) in order to assess effects on diurnal variations in calcium-phosphate homeostasis. Following injection, blood samples were obtained at 0.25, 0.5, 1.0, 1.5, 2, 3, 4, 5, 6...

Logic Learning Machine creates explicit and stable rules stratifying neuroblastoma patients.

Science.gov (United States)

Cangelosi, Davide; Blengio, Fabiola; Versteeg, Rogier; Eggert, Angelika; Garaventa, Alberto; Gambini, Claudio; Conte, Massimo; Eva, Alessandra; Muselli, Marco; Varesio, Luigi

2013-01-01

Neuroblastoma is the most common pediatric solid tumor. About fifty percent of high risk patients die despite treatment making the exploration of new and more effective strategies for improving stratification mandatory. Hypoxia is a condition of low oxygen tension occurring in poorly vascularized areas of the tumor associated with poor prognosis. We had previously defined a robust gene expression signature measuring the hypoxic component of neuroblastoma tumors (NB-hypo) which is a molecular risk factor. We wanted to develop a prognostic classifier of neuroblastoma patients' outcome blending existing knowledge on clinical and molecular risk factors with the prognostic NB-hypo signature. Furthermore, we were interested in classifiers outputting explicit rules that could be easily translated into the clinical setting. Shadow Clustering (SC) technique, which leads to final models called Logic Learning Machine (LLM), exhibits a good accuracy and promises to fulfill the aims of the work. We utilized this algorithm to classify NB-patients on the bases of the following risk factors: Age at diagnosis, INSS stage, MYCN amplification and NB-hypo. The algorithm generated explicit classification rules in good agreement with existing clinical knowledge. Through an iterative procedure we identified and removed from the dataset those examples which caused instability in the rules. This workflow generated a stable classifier very accurate in predicting good and poor outcome patients. The good performance of the classifier was validated in an independent dataset. NB-hypo was an important component of the rules with a strength similar to that of tumor staging. The novelty of our work is to identify stability, explicit rules and blending of molecular and clinical risk factors as the key features to generate classification rules for NB patients to be conveyed to the clinic and to be used to design new therapies. We derived, through LLM, a set of four stable rules identifying a new

Logic Learning Machine creates explicit and stable rules stratifying neuroblastoma patients

Science.gov (United States)

2013-01-01

Background Neuroblastoma is the most common pediatric solid tumor. About fifty percent of high risk patients die despite treatment making the exploration of new and more effective strategies for improving stratification mandatory. Hypoxia is a condition of low oxygen tension occurring in poorly vascularized areas of the tumor associated with poor prognosis. We had previously defined a robust gene expression signature measuring the hypoxic component of neuroblastoma tumors (NB-hypo) which is a molecular risk factor. We wanted to develop a prognostic classifier of neuroblastoma patients' outcome blending existing knowledge on clinical and molecular risk factors with the prognostic NB-hypo signature. Furthermore, we were interested in classifiers outputting explicit rules that could be easily translated into the clinical setting. Results Shadow Clustering (SC) technique, which leads to final models called Logic Learning Machine (LLM), exhibits a good accuracy and promises to fulfill the aims of the work. We utilized this algorithm to classify NB-patients on the bases of the following risk factors: Age at diagnosis, INSS stage, MYCN amplification and NB-hypo. The algorithm generated explicit classification rules in good agreement with existing clinical knowledge. Through an iterative procedure we identified and removed from the dataset those examples which caused instability in the rules. This workflow generated a stable classifier very accurate in predicting good and poor outcome patients. The good performance of the classifier was validated in an independent dataset. NB-hypo was an important component of the rules with a strength similar to that of tumor staging. Conclusions The novelty of our work is to identify stability, explicit rules and blending of molecular and clinical risk factors as the key features to generate classification rules for NB patients to be conveyed to the clinic and to be used to design new therapies. We derived, through LLM, a set of four

Effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with AMI

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Zhi-Bin Kuang

2017-06-01

Full Text Available Objective: To observe the effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with acute myocardial infarction (AMI. Methods: A total of 39 patients with AMI who were admitted in our hospital from March, 2016 to November, 2016 were included in the study and served as the observation group. The peripheral venous blood before and after thrombolysis was collected. The plasma NTproBNP level, related coagulation factors, and fibrinolysis indicators were detected. The cardiac function before treatment was evaluated. A total of 30 healthy individuals who came for physical examinations were served as the control group for contrastive analysis. Results: The plasma NT-proBNP, Fg, and D-D levels before thrombolysis in the observation group were significantly higher than those in the control group, while PT, APTT, and TT in the observation group were significantly shortened. The plasma NT-proBNP and D-D levels 2-48 h after thrombolysis in the observation group were significantly elevated first and reduced later and reached the peak 4 h after treatment, while PT, APTT, and TT were significantly extended first and shortened later. The plasma Fg level was significantly reduced first and elevated later and reached the minimum 4 h after treatment. During the treatment process, in the observation group, 2 had mucocutaneous hemorrhage, 3 had nasal hemorrhage, and 1 had gingival bleeding, but no gastrointestinal bleeding or cerebral hemorrhage occurred. Conclusions: The thrombolytic therapy can effectively reduce the coagulation activity in patients with AMI, strengthen the fibrinolysis activity, and improve the cardiac function.

Ventricular metastasis resulting in disseminated intravascular coagulation

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Davis Ian D

2005-05-01

Full Text Available Abstract Background Disseminated Intravascular Coagulation (DIC complicates up to 7% of malignancies, the commonest solid organ association being adenocarcinoma. Transitional Cell Carcinoma (TCC has rarely been associated with DIC. Case presentation A 74-year-old woman with TCC bladder and DIC was found to have a cardiac lesion suspicious for metastatic disease. The DIC improved with infusion of plasma and administration of Vitamin K, however the cardiac lesion was deemed inoperable and chemotherapy inappropriate; given the patients functional status. We postulate that direct activation of the coagulation cascade by the intraventricular metastasis probably triggered the coagulopathy in this patient. Conclusion Cardiac metastases should be considered in cancer patients with otherwise unexplained DIC. This may influence treatment choices.

Hypo-fractionated radiotherapy in the treatment of breast cancer in elderly patients; Radiotherapie hypofractionnee dans le traitement du cancer du sein de la personne agee

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Merikhi, T.; Meziane, A.; Laarit, I.; Bali, M.S.; Bendjazia-Djemaa, A. [CHU de Constantine, Constantine (Algeria)

2011-10-15

The authors report an assessment on the long term of the efficiency and toxicity of a hypo-fractionated radiotherapy scheme: 5 Gy on d1 and d3, 6,5 Gy on d15 and d17, and 5 Gy on d29 and d31. The study is based on 144 patients treated between 1990 and 2007. Results are presented in terms of average follow-up, of survival rate without relapse by 5 and 8 years. This treatment could be a good solution to reduce therapeutic delays and a good response to expectations of elderly patients suffering from breast cancer. Short communication

Effect of transient postpubertal hypo- and hyperthyroidism on ...

African Journals Online (AJOL)

Effect of transient postpubertal hypo- and hyperthyroidism on reproductive parameters of Iranian broiler breeder hens. ... Egg number, fertility, hatchability, grading of day-old chicks and embryonic developmental stage of unhatched eggs were determined for individual artificially inseminated hen. Effects of PTU and T4 ...

Overview of the coagulation system.

Science.gov (United States)

Palta, Sanjeev; Saroa, Richa; Palta, Anshu

2014-09-01

Coagulation is a dynamic process and the understanding of the blood coagulation system has evolved over the recent years in anaesthetic practice. Although the traditional classification of the coagulation system into extrinsic and intrinsic pathway is still valid, the newer insights into coagulation provide more authentic description of the same. Normal coagulation pathway represents a balance between the pro coagulant pathway that is responsible for clot formation and the mechanisms that inhibit the same beyond the injury site. Imbalance of the coagulation system may occur in the perioperative period or during critical illness, which may be secondary to numerous factors leading to a tendency of either thrombosis or bleeding. A systematic search of literature on PubMed with MeSH terms 'coagulation system, haemostasis and anaesthesia revealed twenty eight related clinical trials and review articles in last 10 years. Since the balance of the coagulation system may tilt towards bleeding and thrombosis in many situations, it is mandatory for the clinicians to understand physiologic basis of haemostasis in order to diagnose and manage the abnormalities of the coagulation process and to interpret the diagnostic tests done for the same.

Overview of the coagulation system

Directory of Open Access Journals (Sweden)

Sanjeev Palta

2014-01-01

Full Text Available Coagulation is a dynamic process and the understanding of the blood coagulation system has evolved over the recent years in anaesthetic practice. Although the traditional classification of the coagulation system into extrinsic and intrinsic pathway is still valid, the newer insights into coagulation provide more authentic description of the same. Normal coagulation pathway represents a balance between the pro coagulant pathway that is responsible for clot formation and the mechanisms that inhibit the same beyond the injury site. Imbalance of the coagulation system may occur in the perioperative period or during critical illness, which may be secondary to numerous factors leading to a tendency of either thrombosis or bleeding. A systematic search of literature on PubMed with MeSH terms ′coagulation system, haemostasis and anaesthesia revealed twenty eight related clinical trials and review articles in last 10 years. Since the balance of the coagulation system may tilt towards bleeding and thrombosis in many situations, it is mandatory for the clinicians to understand physiologic basis of haemostasis in order to diagnose and manage the abnormalities of the coagulation process and to interpret the diagnostic tests done for the same.

Outcomes of Modestly Hypofractionated Radiation for Lung Tumors: Pre- and Mid-Treatment Positron Emission Tomography-Computed Tomography Metrics as Prognostic Factors.

Science.gov (United States)

Harris, Jeremy P; Chang-Halpenny, Christine N; Maxim, Peter G; Quon, Andrew; Graves, Edward E; Diehn, Maximilian; Loo, Billy W

2015-11-01

Many patients with lung tumors have tumors too large for stereotactic ablative radiotherapy and comorbidities precluding concurrent chemotherapy. We report the outcomes of 29 patients treated with hypofractionated radiotherapy (RT) to 60 to 66 Gy in 3-Gy fractions. We also report an exploratory analysis of the prognostic value of the pre- and mid-RT positron emission tomography-computed tomography. Modestly hypofractionated radiation therapy (HypoRT; 60-66 Gy in 3-Gy fractions) allows patients with locally advanced thoracic tumors and poor performance status to complete treatment within a shorter period without concurrent chemotherapy. We evaluated the outcomes and imaging prognostic factors of HypoRT. We retrospectively reviewed the data from all patients with primary and metastatic intrathoracic tumors treated with HypoRT from 2006 to 2012. We analyzed the survival and toxicity outcomes, including overall survival (OS), progression-free survival (PFS), local recurrence (LR), and distant metastasis. We also evaluated the following tumor metrics in an exploratory analysis: gross tumor volume (GTV), maximum standardized uptake value (SUVMax), and metabolic tumor volume using a threshold of ≥ 50% of the SUVMax (MTV50%) or the maximum gradient of fluorine-18 fluorodeoxyglucose uptake (MTVEdge). We assessed the association of these metrics and their changes from before to mid-RT using positron emission tomography-computed tomography (PET-CT) with OS and PFS. We identified 29 patients, all with pre-RT and 20 with mid-RT PET-CT scans. The median follow-up period was 15 months. The 2-year overall and non-small-cell lung cancer-only rate for OS, PFS, and LR, was 59% and 59%, 52% and 41%, and 27% and 32%, respectively. No grade ≥ 3 toxicities developed. The median decrease in GTV, SUVMax, and MTVEdge was 11%, 24%, and 18%, respectively. Inferior OS was associated with a larger pre-RT MTVEdge (P = .005) and pre-RT MTV50% (P = .007). Inferior PFS was associated with a

Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

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Wassim M. Bazzi

2011-01-01

Full Text Available Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS nonischemic laparoscopic partial nephrectomy (NI-LPN utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3% successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL was 1.02/1.07 (=.471. All had negative margins. 12 (20% patients developed complications. 3 (5% developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy.

Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

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Belquiz Amaral Nassaralla

2013-06-01

Full Text Available PURPOSE: To evaluate the thinnest corneal thickness changes during and after corneal collagen cross-linking treatment with ultraviolet-A irradiation, using hypo-osmolar riboflavin solution in thin corneas. METHODS: Eighteen eyes of 18 patients were included in this study. After epithelium removal, iso-osmolar 0.1% riboflavin solution was instilled to the cornea every 3 minutes for 30 minutes. Hypo-osmolar 0.1% riboflavin solution was then applied every 20 seconds for 5 minutes or until the thinnest corneal thickness reached 400 µm. Ultraviolet-A irradiation was performed for 30 minutes. During irradiation, iso-osmolar 0.1% riboflavin drops were applied every 5 minutes. Ultrasound pachymetry was performed at approximately the thinnest point of the cornea preoperatively, after epithelial removal, after iso-osmolar riboflavin instillation, after hypo-osmolar riboflavin instillation, after ultraviolet-A irradiation, and at 1, 6 and 12 months after treatment. RESULTS: Mean preoperative thinnest corneal thickness was 380 ± 11 µm. After epithelial removal it decreased to 341 ± 11 µm, and after 30 minutes of iso-osmolar 0.1% riboflavin drops, to 330 ± 7.6 µm. After hypo-osmolar 0.1% riboflavin drops, mean thinnest corneal thickness increased to 418 ± 11 µm. After UVA irradiation, it was 384 ± 10 µm. At 1, 6 and 12 months after treatment, it was 372 ± 10 µm, 381 ± 12.7, and 379 ± 15 µm, respectively. No intraoperative, early postoperative, or late postoperative complications were noted. CONCLUSIONS: Hypo-osmolar 0.1% riboflavin solution seems to be effective for swelling thin corneas. The swelling effect is transient and short acting. Corneal thickness should be monitored throughout the procedure. Larger sample sizes and longer follow-up are required in order to make meaningful conclusions regarding safety.

Thyroid storm complicated by bicytopenia and disseminated intravascular coagulation.

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Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

2014-07-24

Male, 23. Thyroid storm. Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss. -. -. Endocrinology and Metabolic. Unusual clinical course. The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems.

Impact of liver disease on outcomes of patients hospitalized for epistaxis.

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Mohamed, Omar M; Govindan, Aparna; Filimonov, Andrey; Sylvester, Michael J; Zaki, Michael; Baredes, Soly; Eloy, Jean Anderson

2017-12-01

Liver disease (LD) often results in coagulation abnormalities that may predispose to more severe epistaxis. The purpose of this analysis was to examine characteristics of patients hospitalized for epistaxis with LD and explore the impact of LD on patient outcomes. The 2002 to 2013 National Inpatient Sample was queried for cases with a primary diagnosis of epistaxis. Cases with additional codes meeting the Agency for Healthcare Research and Quality's definition of LD were identified and compared to the non-LD cohort. Out of 39,879 cases meeting inclusion criteria, 3.6% had LD. LD was associated with younger age (55.7 years vs. 67.5 years; P epistaxis, LD resulted in greater morbidity and mortality. Clinicians should be aware of the particular risk that LD bears on the hospitalized epistaxis patient. 2C. Laryngoscope, 127:2691-2697, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of sugammadex on coagulation as detected by rotational thromboelastometry in morbidly obese patients.

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Carron, Michele; Bertini, Diana; Prandini, Tancredi; Fanton, Francesca; Foletto, Mirto; Ori, Carlo; Perissinotto, Egle; Simioni, Paolo

2018-02-01

Sugammadex, which is used to reverse rocuronium-induced neuromuscular blockade, has a limited and transient effect on activated partial thromboplastin time and prothrombin time. However, no data are available on the effects of sugammadex on coagulation in morbidly obese patients, as assessed by rotational thromboelastometry (ROTEM®). Sixty patients received sugammadex 2 mg/kg or 4 mg/kg to reverse moderate or deep rocuronium-induced neuromuscular blockade (N.=30/group) at the end of surgery under desflurane anesthesia. Arterial blood samples were collected before and 3 min and 30 min after sugammadex administration for ROTEM® analysis, including measurements of clotting time (CT), clot formation time, α angle, and maximum clot firmness in INTEM, EXTEM, and FIBTEM assays. Major and minor bleeding events were also monitored during the postoperative period. Sugammadex 2 and 4 mg/kg has a limited and transient (sugammadex dose (500 mg) on the INTEM CT (P=0.002). A regression analysis showed a positive relationship between sugammadex dose and INTEM CT value at 3 min after administration (coefficient = 0.052 s; 95% CI: 0.005-0.098 s; P=0.03). No major or minor bleeding events were observed in either group during the postoperative period. Sugammadex produces a slight effect on coagulation in morbidly obese patients, without increasing the risk for postoperative bleeding.

Health-related quality of life in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism.

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Underbjerg, L; Sikjaer, T; Rejnmark, L

2018-03-09

Nonsurgical hypoparathyroidism (NS-HypoPT) and pseudohypoparathyroidism (PHP) are rare diseases, with a prevalence of 2/100.000 and 1/100.000, respectively. Only few studies on Quality of Life (QoL) among patients with Ns-HypoPT and PHP are available. We aimed to investigate the QoL among patients with Ns-HypoPT and PHP including information about education. A cohort study with patients identified from a previously epidemiological study. Fifty seven patients with Ns-HypoPT and 30 patients with PHP. The well-validated questionnaires SF-36v2 and WHO-5 Well Being Index. Results compared to norm-based material, disease-specific norm-based material and patients with postsurgical HypoPT RESULTS: SF36v2 showed a significantly reduced score in all eight subdomains in patients with NS-HypoPT compared with a norm-based population. PHP patients scored lower in five subdomains. Females were more affected than males. Compared with postsurgical HypoPT, Ns-HypoPT and PHP are compatible at most domains. At the domains Physical Function, Social Function and Mental Health, Ns-HypoPT and PHP patients scored significantly lower (P all  PHP (P = .67). A WHO-5 score below 28 indicates depression (NS-HypoPT=7; PHP=3, P = .71), whereas a score between 28-50 suggesting poor emotional well-being (NS-HypoPT=19; PHP=5, P = .13). The remaining patients scored above 50 suggesting well-being. QoL is impaired equally among patients with Ns-HypoPT and PHP. © 2018 John Wiley & Sons Ltd.

Activation and coagulation biomarkers are independent predictors of the development of opportunistic disease in patients with HIV infection

DEFF Research Database (Denmark)

Rodger, Alison J; Fox, Zoe; Lundgren, Jens

2009-01-01

BACKGROUND: Activation and coagulation biomarkers were measured within the Strategies for Management of Antiretroviral Therapy (SMART) trial. Their associations with opportunistic disease (OD) in human immunodeficiency virus (HIV)-positive patients were examined. METHODS: Inflammatory (high-sensi...

Radical hypo-fractionated radiotherapy with volumetric modulated arc therapy in lung cancer. A retrospective study of elderly patients with stage III disease

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Franceschini, D. [Humanitas Cancer Center and Research Hospital, Radiotherapy and Radiosurgery Department, Milan (Italy); Istituto Clinico Humanitas Cancer Center, Rozzano (Milan) (Italy); De Rose, F.; Navarria, P.; Clerici, E.; Franzese, C.; Comito, T.; Tozzi, A.; Iftode, C.; D' Agostino, G. [Humanitas Cancer Center and Research Hospital, Radiotherapy and Radiosurgery Department, Milan (Italy); Cozzi, L.; Sorsetti, M. [Humanitas Cancer Center and Research Hospital, Radiotherapy and Radiosurgery Department, Milan (Italy); Humanitas University, Department of Biomedical Sciences, Milan (Italy)

2017-05-15

This study aimed to analyse the feasibility and acute toxicity of radical hypo-fractionated radiotherapy (RT) for elderly patients with non-small-cell lung cancer (NSCLC). We conducted a retrospective evaluation of treatment with volumetric modulated arc therapy (VMAT) of elderly patients affected by stage III inoperable NSCLC. The dose prescription was 56 Gy in 20 fractions, 55 Gy in 22 fractions, or 50 Gy in 20 fractions. Target volume included only the primary lesion and the infiltrated lymph nodes. The primary end point was acute and late toxicity, while secondary end points were progression-free survival (PFS), and overall survival (OS). In all, 41 patients were included in this analysis. The mean age of the patients was 78.6 years, and 22 patients had staged IIIA while 19 patients had stage IIIB disease. All but one patient had pathological nodal involvement; 15 patients received chemotherapy before RT. Acute grade 1-2 toxicity was recorded in 25 (61%) patients. Late toxicity was recorded in 13 (32%) patients. No cases of G3 or G4 toxicity were recorded. Complete response was obtained in two (5%) patients, 26 (63%) showed a partial response, and two (5%) experience disease progression. At a mean follow-up of 9.9 months (range, 1.1-25.4), 17 patients had died from disease progression, one died from other causes, and 23 were alive. Median OS was 13.7 ± 1.5 months (95% CI: 10.7-16.7), OS at 12 and 18 months was 51.3 ± 9.5% and 35.1 ± 10.1%, respectively. Median PFS was 13.7 ± 2.3 months (95% CI: 9.1-18.2), and PFS at 12 and 18 months was 50.1 ± 9.9% and 38.9 ± 10.4%, respectively. Radical hypo-fractionated VMAT is a promising treatment for locally advanced NSCLC in the elderly. The use of hypo-fractionated radiotherapy for lung cancer in older patients can be considered a valuable approach, particularly for patients with poor performance status or refusing other treatment approaches. (orig.) [German] Durchfuehrbarkeit und Nebenwirkungen der radikalen

Preoperative Detailed Coagulation Tests Are Required in Patients With Noonan Syndrome.

Science.gov (United States)

Morice, Anne; Harroche, Annie; Cairet, Pascale; Khonsari, Roman H

2017-12-29

Patients with Noonan syndrome often require surgery at young ages. They are at high risk of perioperative bleeding from coagulation defects that might not have been detected by routine screening. These risks are rarely described in the oral and maxillofacial surgery (OMS) literature. The aim of this study was to evaluate the perioperative bleeding risks associated with Noonan syndrome and to propose preoperative guidelines. This report describes a retrospective case series of patients with Noonan syndrome who underwent OMS procedures during a continuous observational period (2013 through 2016) in the authors' center. Clinical data, blood screening test results, and perioperative bleeding were analyzed. Five patients (age, 4 to 20 yr) with Noonan syndrome who underwent OMS procedures were included in this study. One patient presented a spontaneous bleeding tendency (epistaxis requiring cauterization). Blood screening showed clotting defects in 3 patients. One patient presented abnormal perioperative bleeding owing to a mild defect in factor XI. Patients with Noonan syndrome must be referred to a hematologist for specific preoperative investigations and for adapted perioperative management. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The prognostic value of thrombelastography in identifying neurosurgical patients with worse prognosis

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Windeløv, Nis A; Welling, Karen-Lise; Ostrowski, Sisse R

2011-01-01

Coagulopathy in patients with intracranial haemorrhage or traumatic brain injury (TBI) is associated with clinical deterioration and worse outcome. Whole blood viscoelastic haemostatic assays, like thrombelastography (TEG), might aid conventional coagulation assays in identification of patients w...... prognosis. Low concordance with conventional coagulation assays indicates that TEG might be valuable in identifying patients with clinically relevant coagulopathy....

Murine study of portal hypertension associated endothelin-1 hypo-response.

Science.gov (United States)

Theodorakis, Nicholas; Maluccio, Mary; Skill, Nicholas

2015-04-28

To investigate endothelin-1 hypo-responsive associated with portal hypertension in order to improve patient treatment outcomes. Wild type, eNOS(-/-) and iNOS(-/-) mice received partial portal vein ligation surgery to induce portal hypertension or sham surgery. Development of portal hypertension was determined by measuring the splenic pulp pressure, abdominal aortic flow and portal systemic shunting. To measure splenic pulp pressure, a microtip pressure transducer was inserted into the spleen pulp. Abdominal aortic flow was measured by placing an ultrasonic Doppler flow probe around the abdominal aorta between the diaphragm and celiac artery. Portal systemic shunting was calculated by injection of fluorescent microspheres in to the splenic vein and determining the percentage accumulation of spheres in liver and pulmonary beds. Endothelin-1 hypo-response was evaluated by measuring the change in abdominal aortic flow in response to endothelin-1 intravenous administration. In addition, thoracic aorta endothelin-1 contraction was measured in 5 mm isolated thoracic aorta rings ex-vivo using an ADI small vessel myograph. In wild type and iNOS(-/-) mice splenic pulp pressure increased from 7.5 ± 1.1 mmHg and 7.2 ± 1 mmHg to 25.4 ± 3.1 mmHg and 22 ± 4 mmHg respectively. In eNOS(-/-) mice splenic pulp pressure was increased after 1 d (P = NS), after which it decreased and by 7 d was not significantly elevated when compared to 7 d sham operated controls (6.9 ± 0.6 mmHg and 7.3 ± 0.8 mmHg respectively, P = 0.3). Abdominal aortic flow was increased by 80% and 73% in 7 d portal vein ligated wild type and iNOS when compared to shams, whereas there was no significant difference in 7 d portal vein ligated eNOS(-/-) mice when compared to shams. Endothelin-1 induced a rapid reduction in abdominal aortic blood flow in wild type, eNOS(-/-) and iNOS(-/-) sham mice (50% ± 8%, 73% ± 9% and 47% ± 9% respectively). Following portal vein ligation endothelin-1 reduction in blood flow

Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis

Directory of Open Access Journals (Sweden)

Fenny

2011-03-01

Full Text Available Sepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT, activated partial thromboplastin time (aPTT, fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58% with outcome decompensated DIC and 28 sepsis patients (42% with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively. Conclusions, prothrombin time, aPTT, fibrinogen are the test to know coagulation activation. Hemostasis parameter to predict decompensated DIC in sepsis patients are the shorten PT, aPTT, and the increased fibrinogen

Selection of Sperm Based on Hypo-Osmotic Swelling May Improve ICSI Outcome: A Preliminary Prospective Clinical Trial

Directory of Open Access Journals (Sweden)

Nasim Charehjooy

2014-03-01

Full Text Available Background: The intra-cytoplasmic sperm injection (ICSI technique selects sperm according to morphology and motility. However, these parameters cannot predict the chromatin integrity of sperm. Considering the detrimental effects of DNA-damaged sperm on reproductive outcomes, novel sperm selection procedures have been proposed to circumvent the possibility of inseminating DNA-damaged sperm. It has been shown that different potential hypo-osmotic swelling test (HOST patterns possess the potential to differentiate between sperm that have intact or damaged chromatin. Therefore, for the first time, this preliminary study evaluates the role of HOST as a sperm selection procedure in a clinical setting. Materials and Methods: In this preliminary prospective clinical trial study, we divided infertile couples diagnosed with male infertility into two groups. In the treatment group (n=39, half of the oocytes were inseminated by sperm selected following density gradient centrifugation (DGC group. The remaining oocytes from the treatment group were inseminated by sperm chosen according to HOST pattern (c, d or e following DGC processing (HOST group. In the control group (n=63, all oocytes were inseminated by sperm chosen after DGC. Results: There was a significantly higher percentage of embryos that had good quality, implantation, and chemical pregnancy rates in the HOST group compared to the DGC group (p≤0.05. Conclusion: This study has shown that selecting sperm according to membrane functionality (HOST pattern rather morphology and viability may open a new window in our approach for determining the appropriate sperm for ICSI, particularly in individuals with severe male infertility (Registration Number: IRCT201307087223N2.

Relationship between Job Stress and Hypo-high-density Lipoproteinemia of Chinese Workers in Shanghai: The Rosai Karoshi Study.

Science.gov (United States)

Muratsubaki, Tomohiko; Hattori, Tomomi; Li, Jue; Fukudo, Shin; Munakata, Masanori

2016-10-20

Karoshi, or death due to overwork, has now become a serious social problem in China. Worsening of cardiovascular risks by stress might initiate karoshi. Many studies have examined the relationship between job stress and obesity, hypertension, and type 2 diabetes mellitus, but less evidence exists for dyslipidemia like hypo-high-density lipoproteinemia (hypo-HDL). The aim of this study was to investigate the relationship between job stress and hypo-HDL of Chinese workers in Shanghai. We studied 2219 Chinese workers in Shanghai, who participated in the Japan-China cooperative study for the prevention of karoshi. A questionnaire was administered to examine the lifestyle characteristics, job category, weekly working hours, and job stress. Job demand and job control were quantified using the National Institute for Occupational Safety and Health questionnaire. Modified job strain measure was defined by the combination of low job control and high demand. Hypo-HDL was defined as plasma high-density lipoprotein cholesterol concentration of <1.04 mmol/L (40 mg/dl). Multivariate logistic regression analysis was performed for hypo-HDL as a dependent variable. Modified job strain was not related to hypo-HDL either in men or women. In men, multivariate adjusted odds ratio (OR) for having hypo-HDL was significantly higher in the lowest job control tertile compared with the highest job control tertile (OR = 1.39, 95% confidence interval [CI] 1.03-1.87, P = 0.034). In the same model, a similar trend was observed for women, but it did not reach a statistically significant level (OR = 1.51, 95% CI, 0.88-2.56, P = 0.132). A low level of job control but not modified job strain was significantly related to higher prevalence of hypo-HDL of Chinese workers in Shanghai.

Hypo-fractionated whole breast irradiation: Pro and cons; Irradiation hypofractionnee dans le cancer du sein: pour ou contre?

Energy Technology Data Exchange (ETDEWEB)

Cutuli, B. [Institut du cancer Courlancy, 38, rue de Courlancy, 51100 Reims (France); Fourquet, A. [Institut Curie, 26, rue d' Ulm, 75005 Paris (France)

2011-10-15

The continuous increase of breast cancer (BC) incidence, the logistic constraints of the protracted standard 5-week radiations regimen have led to test short hypo-fractionated whole breast radiation therapy schemes. Three prospective randomized trials and a pilot trial have been published. Large numbers of patients were included, with follow-up duration ranging from 5 to 12 years. The conclusions of these trials were similar, showing local control and toxicity equivalent to those of the standard regimen, and supporting the use of three schemes: 42.5 Gy/16 fractions/3 weeks, 40 Gy/15 fractions/3 weeks or 41.6 Gy/13 fractions/5 weeks. However, the patients in these trials had favourable prognostic factors, were treated to the breast only and the boost dose, when indicated, was delivered with a standard fractionation. Hypo-fractionated treatment can only be recommended in patients treated to the breast only, without nodal involvement, with grade < 3 tumours and who are not candidate to chemotherapy. If a boost is to be given, a standard fractionation should be used. Particular care should be taken to avoid heterogeneities leading to high fractional doses to organs at risk (lung and heart). (authors)

Early markers of blood coagulation and fibrinolysis activation in Argentine hemorrhagic fever

NARCIS (Netherlands)

Heller, M. V.; Marta, R. F.; Sturk, A.; Maiztegui, J. I.; Hack, C. E.; Cate, J. W.; Molinas, F. C.

1995-01-01

Junin virus, an arenaviridae, is the etiological agent of Argentine hemorrhagic fever. In addition to thrombocytopenia, patients present several alterations in both the blood coagulation and the fibrinolytic system, but diffuse intravascular coagulation could not be demonstrated. To investigate

The prospects of application of natural antioxidants in correction of blood coagulation in patients with breast cancer during radiation therapy

International Nuclear Information System (INIS)

Syimonova, L.Yi.; Byilogurova, L.V.; Gertman, V.Z.; Pushkar, S.M.; Muzikant, P.M.; Nesterenko, G.Yi.

2008-01-01

As an accompanying therapy of the patients with BC Bipolan produced positive effect on coagulation homeostasis. By the end of the course of treatment the indices of homeostasis normalized in the experimental group of the patients; manifestations of DIC syndrome and thromboembolic complications were controlled

Development of Coagulation Factor Probes for the Identification of Procoagulant Circulating Tumor Cells

Energy Technology Data Exchange (ETDEWEB)

Tormoen, Garth W.; Cianchetti, Flor A. [Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR (United States); Bock, Paul E. [Department of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, TN (United States); McCarty, Owen J. T., E-mail: tormoeng@ohsu.edu [Department of Biomedical Engineering, Oregon Health and Science University, Portland, OR (United States); Department of Cell and Developmental Biology, Oregon Health and Science University, Portland, OR (United States); Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health and Science University, Portland, OR (United States)

2012-09-06

Metastatic cancer is associated with a hypercoagulable state, and pathological venous thromboembolic disease is a significant source of morbidity and the second leading cause of death in patients with cancer. Here we aimed to develop a novel labeling strategy to detect and quantify procoagulant circulating tumor cells (CTCs) from patients with metastatic cancer. We hypothesize that the enumeration of procoagulant CTCs may be prognostic for the development of venous thrombosis in patients with cancer. Our approach is based on the observation that cancer cells are capable of initiating and facilitating cell-mediated coagulation in vitro, whereby activated coagulation factor complexes assemble upon cancer cell membrane surfaces. Binding of fluorescently labeled, active site-inhibited coagulation factors VIIa, Xa, and IIa to the metastatic breast cancer cell line, MDA-MB-231, non-metastatic colorectal cell line, SW480, or metastatic colorectal cell line, SW620, was characterized in a purified system, in anticoagulated blood and plasma, and in plasma under conditions of coagulation. We conclude that a CTC labeling strategy that utilizes coagulation factor-based fluorescent probes may provide a functional assessment of the procoagulant potential of CTCs, and that this strategy is amenable to current CTC detection platforms.

Long term results of hypo-fractionated mammary radiotherapy as exclusive treatment of elderly patients suffering from a beast cancer; Resultats a long terme de la radiotherapie mammaire hypofractionnee comme traitement exclusif des patientes agees souffrant d'un cancer du sein

Energy Technology Data Exchange (ETDEWEB)

Chargari, C.; Kirova, Y.; Laki, F.; Savignoni, A.; Dorval, D.; Dendale, R.; Bollet, M.; Fourquet, A.; Campana, F. [Institut Curie, 75 - Paris (France)

2010-10-15

The author discuss the results obtained on 29 elderly patients exclusively treated between 1995 and 1999 by mammary irradiation (32.5 Gy) in 5 fractions over 5 weeks, and then with a lower additional irradiation (13 Gy) in two fractions. They discuss the efficiency of this hypo-fractionated radiotherapy without breast conserving surgery. Short communication

Life-threatening urethral hemorrhage after placement of a Foley catheter in a patient with uroseptic disseminated intravascular coagulation due to chronic urinary retention induced by untreated benign prostatic hyperplasia.

Science.gov (United States)

Ikegami, Yukihiro; Yoshida, Keisuke; Imaizumi, Tsuyoshi; Isosu, Tsuyoshi; Kurosawa, Shin; Murakawa, Masahiro

2016-10-01

A 77-year-old man with severe septic disseminated intravascular coagulation following urinary infection was transported to our hospital. He had developed urinary retention induced by untreated prostatic hyperplasia. Immediate drainage with a Foley catheter was successfully carried out, but the hematuria progressed to life-threatening hemorrhage. Complete hemostasis was impossible by surgical treatment because the tissue around the prostatic urethra was very fragile and hemorrhagic. Organized treatments (continuous hemodiafiltration combined with polymyxin-B immobilized fiber column hemoperfusion and systemic treatment with antibiotics and coagulation factors) were commenced soon after the operation. The patient eventually recovered from the septic disseminated intravascular coagulation. This case report illustrates the risk of placement of Foley catheters in patients with severe septic disseminated intravascular coagulation.

TRAITEMENT DES EAUX USEES PAR COAGULATION-FLOCULATION EN UTILISANT LE SULFATE D’ALUMINIUM COMME COAGULANT

OpenAIRE

Nora SEGHAIRI; Leila MIMECHE; Adel BOUZID; Yassir AYACHI

2017-01-01

Domestic wastewater treatment by coagulation-flocculation is widely used internationally. This treatment reduces color and turbidity, indicating organic and inorganic contaminants, but at acceptable levels for treated waste water discharged into the receiving environment. The objective of this study is to optimize the treatment of wastewater by coagulation-flocculation using aluminum sulphate as a coagulant. Various reaction parameters are taken into account, such as the coagulant dose,...

Genetic Polymorphisms and Weight Loss in Obesity: A Randomised Trial of Hypo-Energetic High- versus Low-Fat Diets

Science.gov (United States)

Sørensen, Thorkild I. A; Boutin, Philippe; Taylor, Moira A; Larsen, Lesli H; Verdich, Camilla; Petersen, Liselotte; Holst, Claus; Echwald, Søren M; Dina, Christian; Toubro, Søren; Petersen, Martin; Polak, Jan; Clément, Karine; Martínez, J. Alfredo; Langin, Dominique; Oppert, Jean-Michel; Stich, Vladimir; Macdonald, Ian; Arner, Peter; Saris, Wim H. M; Pedersen, Oluf; Astrup, Arne; Froguel, Philippe

2006-01-01

Objectives: To study if genes with common single nucleotide polymorphisms (SNPs) associated with obesity-related phenotypes influence weight loss (WL) in obese individuals treated by a hypo-energetic low-fat or high-fat diet. Design: Randomised, parallel, two-arm, open-label multi-centre trial. Setting: Eight clinical centres in seven European countries. Participants: 771 obese adult individuals. Interventions: 10-wk dietary intervention to hypo-energetic (−600 kcal/d) diets with a targeted fat energy of 20%–25% or 40%–45%, completed in 648 participants. Outcome Measures: WL during the 10 wk in relation to genotypes of 42 SNPs in 26 candidate genes, probably associated with hypothalamic regulation of appetite, efficiency of energy expenditure, regulation of adipocyte differentiation and function, lipid and glucose metabolism, or production of adipocytokines, determined in 642 participants. Results: Compared with the noncarriers of each of the SNPs, and after adjusting for gender, age, baseline weight and centre, heterozygotes showed WL differences that ranged from −0.6 to 0.8 kg, and homozygotes, from −0.7 to 3.1 kg. Genotype-dependent additional WL on low-fat diet ranged from 1.9 to −1.6 kg in heterozygotes, and from 3.8 kg to −2.1 kg in homozygotes relative to the noncarriers. Considering the multiple testing conducted, none of the associations was statistically significant. Conclusions: Polymorphisms in a panel of obesity-related candidate genes play a minor role, if any, in modulating weight changes induced by a moderate hypo-energetic low-fat or high-fat diet. PMID:16871334

Irregular echogenic foci representing coagulation necrosis: a useful but perhaps under-recognized EUS echo feature of malignant lymph node invasion.

Science.gov (United States)

Bhutani, Manoop S; Saftoiu, Adrian; Chaya, Charles; Gupta, Parantap; Markowitz, Avi B; Willis, Maurice; Kessel, Ivan; Sharma, Gulshan; Zwischenberger, Joseph B

2009-06-01

Coagulation necrosis has been described in malignant lymph nodes. Our aim was to determine if coagulation necrosis in mediastinal lymph nodes imaged by EUS could be used as a useful echo feature for predicting malignant invasion. Patients with known or suspected lung cancer who had undergone mediastinal lymph node staging by EUS. Tertiary Care university hospital. An expert endosonographer blinded to the final diagnosis, reviewed the archived digital EUS images of lymph nodes prior to being sampled by FNA. LNs positive for malignancy by FNA were included. The benign group included lymph node images with either negative EUS-FNA or lymph nodes imaged by EUS but not subjected to EUS-FNA, with surgical correlation of their benign nature. 24 patients were included. 8 patients were found to have coagulation necrosis. 7/8 patients had positive result for malignancy by EUS-FNA. One patient determined to have coagulation necrosis had a non-malignant diagnosis indicating a false positive result. 16 patients had no coagulation necrosis. In 6 patients with no coagulation necrosis, the final diagnosis was malignant and in the remaining 10 cases, the final diagnosis was benign. For coagulation necrosis as an echo feature for malignant invasion, sensitivity was 54%, specificity was 91%, positive predictive value was 88%, negative predictive value was 63% and accuracy was 71%. Coagulation necrosis is a useful echo feature for mediastinal lymph node staging by EUS.

Blood coagulation factors as inflammatory mediators

NARCIS (Netherlands)

Schoenmakers, Saskia H. H. F.; Reitsma, Pieter H.; Spek, C. Arnold

2005-01-01

After the first observations about blood coagulation by Hippocrates, it took until the early 1900s before the classic theory of blood coagulation was presented. As more and more other coagulation factors were discovered, the four-factor coagulation scheme became more complex, but better understood,

[Evaluation of selected parameters of blood coagulation and fibrinolysis system in patients undergoing total hip replacement surgery with normovolemic hemodilution procedure and standard enoxaparine prophylaxis].

Science.gov (United States)

Piecuch, Wiesław; Sokołowska, Bozena; Dmoszyńska, Anna; Furmanik, Franciszek

2003-01-01

The aim of the study was to evaluate selected blood coagulation and fibrinolysis parameters in patients undergoing total hip replacement surgery with normovolemic hemodilution and standard enoksaparine profilaxis. The study included 66 patients undergoing hip replacement surgery. The group consisted of 51 women and 15 men, within the age range of 47-78, the mean age was 64. In 32 (subgroup II) patients the surgery was performed with the use of normovolemic hemodilution, in 34 (subgroup I) the hemodilution procedure was not applied. The enoksaparine as prophylaxis started 12 hours prior to surgery and continued during hospitalisation. The examination of the coagulation system was performed: on the day of the operation in the morning, on the day of the operation in the evening and on the first day after operation. We determined the concentrations of TAT and PAP complexes, prothrombin fragments 1 + 2 (F1 + 2) and d-dimers (DD). 1) during total hip replacement surgery and particularly in the period of the first 12 hours after the procedure marked activation of coagulation and fibrinolysis occurRed; 2) the application of the hemodilution procedure does not influence significantly the degree of coagulation and fibrinolysis disorders in the perioperative period, but could reduced incidence of thromboembolic complications in the postoperative period.

Coagulation performance of a novel poly-ferric-acetate (PFC) coagulant in phosphate-kaolin synthetic water treatment

Energy Technology Data Exchange (ETDEWEB)

Wei, Yanxin; Lu, Jinpeng; Dong, Xiongzi; Yao, Chengli [Hefei Normal University, Hefei (China); Hao, Jianwen [Anhui Vocational and Technical College, Hefei (China)

2017-10-15

The process of coagulation-flocculation is increasingly applied in wastewater treatment. And the polymerized inorganic coagulants are widely used among these coagulation-flocculation processes. However, conventional coagulants using sulfates or chlorides as counter anion may give rise to corrosion. The purpose of this study was to synthesize PFC coagulants in which acetate is used as counter anion. The influences on the preparation of PFC were optimized. The synthesis was done at the optimum conditions, such as temperature of 60 .deg. C, the Fe/CH{sub 3}COOH molar ratio of 1 : 4.0 and reaction time of 6 h, respectively. The prepared PFC coagulants were characterized by Fourier transform infrared (FTIR) spectrophotometry and scanning electron microscopy (SEM). PFC was found to mainly form complexation polymeric species and present more cluster and lamellar structure. A series of jar tests were carried out to study the coagulation performance of PFC and PFS in phosphate-kaolin synthetic water treatment. Results showed that the coagulation performance of PFC was more efficient than PFS's in terms of the phosphorus removal efficiency and the residual turbidity. Due to using acetate as counter anion to iron, PFC is less harmful to the processes of water treatment and equipment than that of the conventional coagulants applied chlorides or sulfates. Therefore, PFC is a promising coagulant in the process of corrosion sensitive applications and the process of wastewater containing phosphorus treatment.

Self-reported creativity in bipolar disorder: prevalence, types and associated outcomes in mania versus hypomania.

Science.gov (United States)

McCraw, Stacey; Parker, Gordon; Fletcher, Kathryn; Friend, Paul

2013-12-01

Bipolar (BP) disorder has been linked to creativity following investigation of prominent artists and controlled trials of creativity in BP disorder patients. However, it is unclear whether creativity is differentially expressed across the BP I and BP II subtypes. 219 patients (aged 19-63 years) diagnosed with BP disorder by clinical interview and DSM-IV criteria were asked whether they tended to be more creative during hypo/manic episodes, and answered five questions about personality styles associated with creativity. Qualitative analyses were performed on a smaller subset of 69 BP patients (n=19 BP I, n=50 BP II) who provided written responses of the types of creative activities engaged in when hypo/manic and any perceived advantages or disadvantages of their creative pursuits. 82% of BP patients affirmed being creative when hypo/manic, with comparable results for the BP I and BP II subtypes (84% and 81% respectively). Both BP subtypes engaged mostly in writing, painting, work or business ideas and 'other' forms of art; however BP II patients were more likely to draw and be musical. Both subgroups reported the consequences of feeling good, being productive or quitting their project. BP I patients were more likely to overspend during their creative highs while BP II patients were more likely to experience improved focus and clarity. BP patients affirming creative highs were significantly more likely to report creative personality styles more generally outside of a mood episode. BP patients' self-reported creative activities were not retrospectively judged for quality or originality and so may reflect common creative abilities rather than exceptional quality. The impact of depressive episodes on creativity was not assessed. Uneven sample sizes in the BP I and BP II subgroups may have compromised statistical power. Creativity during hypo/manic episodes was extremely common in both BP subtypes. While some nuances in activity type and outcomes were observed, no

Association of Gender With Outcome and Host Response in Critically Ill Sepsis Patients.

Science.gov (United States)

van Vught, Lonneke A; Scicluna, Brendon P; Wiewel, Maryse A; Hoogendijk, Arie J; Klein Klouwenberg, Peter M C; Ong, David S Y; Cremer, Olaf L; Horn, Janneke; Franitza, Marek; Toliat, Mohammad R; Nürnberg, Peter; Bonten, Marc M J; Schultz, Marcus J; van der Poll, Tom

2017-11-01

To determine the association of gender with the presentation, outcome, and host response in critically ill patients with sepsis. A prospective observational cohort study in the ICU of two tertiary hospitals between January 2011 and January 2014. All consecutive critically ill patients admitted with sepsis, involving 1,815 admissions (1,533 patients). The host response was evaluated on ICU admission by measuring 19 plasma biomarkers reflecting organ systems implicated in sepsis pathogenesis (1,205 admissions) and by applying genome-wide blood gene expression profiling (582 admissions). Sepsis patients admitted to the ICU were more frequently males (61.0%; p < 0.0001 vs females). Baseline characteristics were not different between genders. Urosepsis was more common in females; endocarditis and mediastinitis in men. Disease severity was similar throughout ICU stay. Mortality was similar up to 1 year after ICU admission, and gender was not associated with 90-day mortality in multivariate analyses in a variety of subgroups. Although plasma proteome analyses (including systemic inflammatory and cytokine responses, and activation of coagulation) were largely similar between genders, females showed enhanced endothelial cell activation; this difference was virtually absent in patients more than 55 years old. More than 80% of the leukocyte blood gene expression response was similar in male and female patients. The host response and outcome in male and female sepsis patients requiring ICU admission are largely similar.

Visual Outcome after Laser Photocoagulation for Stage 4 ...

African Journals Online (AJOL)

Objective: The objectives of this research is to evaluate the visual outcome after peripheral laser photo-coagulation for Goldberg stage-4 proliferative sickle cell retinopathy patients seen in Eye Foundation Hospital Lagos between January and December 2002. Methodology: A hospital-based retrospective case review study ...

Postprandial triglycerides and blood coagulation.

Science.gov (United States)

Silveira, A

2001-01-01

Most of our lifetime we spend in the postprandial state. Postprandial triglyceridemia may represent a procoagulant state involving disturbances of both blood coagulation and fibrinolysis, in particular due to elevation of the plasma levels of activated factor VII (VIIa) and plasminogen activator inhibitor (PAI-1). Therefore, disturbances of the hemostatic system might, at least partly, account for by the link between hypertriglyceridemia and coronary heart disease (CHD). Factor VIIa is the first enzyme of the blood coagulation system and serves a priming function for triggering of the clotting cascade. The coagulant activity of factor VII (VIIc, total activity of factor VII in plasma) was identified as an independent predictor of myocardial infarction in initially healthy middle-aged men, and particularly of fatal coronary events, and both serum cholesterol and triglyceride concentrations correlated positively with the VIIc level. Addition of fat to diet has been consistently shown to cause a rapid conversion of the factor VII zymogen into its active form (VIIa) whereas the concentration of total protein is unaffected. Postprandial activation of factor VII is dependent on lipolytic activity and it is mainly supported by large triglyceride-rich lipoprotein of the VLDL class. Studies in vivo with specific coagulation factor-deficient patients indicate that factor IX is essential for the postprandial activation of factor VII. The basal generation of thrombin seems to be unaffected by increased plasma levels of VIIa. However, since VIIa-tissue factor complex is responsible for the initiation of the coagulation cascade, increased generation of VIIa in the postprandial state would increase the potential for thrombin production in the event of plaque rupture. Plasminogen activator inhibitor-1 (PAI-1) is the major physiological inhibitor of the plasminogen activators in the circulation and thereby the principal inhibitor of the fibrinolytic system. Postprandial

Removal of Dye in Wastewater by Adsorption-Coagulation Combined System with Hibiscus sabdariffa as the Coagulant

Directory of Open Access Journals (Sweden)

Hoong Ho Nicholas Jian

2018-01-01

Full Text Available The conventional process to treat dye wastewater is the physicochemical treatment such as coagulation, flocculation and adsorption process. A new approach has been demonstrated to treat Congo red dye wastewater, which is the adsorption-coagulation hybrid process. Natural coagulant extracted from Hibiscus sabdariffa seeds is used as the coagulant while activated carbon is used as the adsorbent in this case study. The objective of this experiment is to study the significant factors that will affect the efficiency of dye removal. Then, the optimum conditions for the hybrid process is determined using Respond Surface Methodology (RSM. The variables are pH, initial dye concentration, coagulant dosage and adsorbent dosage while the response of experiment is the dye removal percentage. A three-level and four-variable Box-Behnken design (BBD is used for the RSM. A total of 27 sets of experimental results is required to determine the optimum conditions. Jar test is used to conduct the experiment with the addition of coagulant and adsorbent simultaneously. Based on the regression model analysis and ANOVA, the highly significant factors that contribute to the dye removal efficiency through adsorption-coagulation hybrid process are pH of solution and initial dye concentration. The RSM results shows that the optimised process parameters for adsorption-coagulation hybrid process with Hibiscus sabdariffa seeds as the coagulant and activated carbon as the adsorbent are pH 2, initial dye concentration of 385 ppm, coagulant dosage of 209 mg/L and adsorbent dosage of 150 mg/L. The dye removal reaches up to 96.67% under optimum parameters.

The investigation of coagulation activity of natural coagulants extracted from different strains of common bean

Directory of Open Access Journals (Sweden)

Šćiban Marina B.

2010-01-01

Full Text Available Coagulation and flocculation by adding chemicals are the methods that are usually used for removal of water turbidity. This study is concerned with the coagulation activity of extracts of various strains of bean. The aim was to ascertain if bean varieties influence coagulation activity. Active components were extracted from 1 g of ground sample with 100 ml distilled water. Contents of dry matter and nitrogen were specified in the solid samples, and the content of soluble nitrogen was determined in the extracts. These data were used to calculate the efficiency of extraction of nitrogen-containing compounds. The coagulation activity was assessed by jar test using synthetic turbid water, of the initial pH 9 and turbidity 35 NTU. The jar test was carried out by adding different amounts of extracts to model water, and stirring the content. After sedimentation for 1 h, residual turbidity was determined by turbidimeter and coagulation activity was calculated. The increment of organic matter concentration after the coagulation was also determined. These experiments confirmed that extracts of all investigated strains of bean could be used successfully as natural coagulants.

Factor xiii deficiency in children-clinical presentation and outcome

International Nuclear Information System (INIS)

Fadoo, Z.; Saleem, A.F.

2008-01-01

To determine the demographic features and clinical outcome of children with Factor XIII deficiency. Records of all hospitalized pediatric patients with discharge diagnosis of FXIII D, on the basis of factor XIII assay 5 mol/L urea test were retrospectively reviewed and abstracted on a pre-specified proforma. Demographic features, coagulation profile, family history and outcomes were noted. A total of 10 charts were reviewed. There were 5 boys and 5 girls. Almost all the children (9/10) were less than 5 years of age, out of whom 5 (50%) were infants, and 3 were neonates. Bruises and prolonged bleeding after trauma was the major presenting complaints in 80%, followed by prolonged bleeding from the umbilical stump in 2 patients. Nine patients had past history of prolonged umbilical bleeding. Two patients had history of FXIII D in siblings, while 2 had history of prolonged bleeding in other family members (cause unknown). Consanguinity was present in 80% of the families. Initial coagulation screen were normal in all patients. Two patients had intracranial hemorrhage, proved on neuro-imaging, were managed with plasma infusions and required craniotomy. The rest were managed conservatively with plasma transfusions. All were discharged alive in good clinical condition. Almost all were followed regularly in clinic with monthly cryoprecipitate transfusions. Although factor XIII deficiency is a rare genetic disorder in children with history of bruising, prolonged umbilical bleeding, family history of bleeding and consanguinity with normal initial coagulation screen (PT, APTT and platelets), FXIII D should be ruled out. (author)

Effects of coagulation temperature on measurements of complement function in serum samples from patients with systemic lupus erythematosus

DEFF Research Database (Denmark)

Baatrup, G; Sturfelt, G; Junker, A

1992-01-01

Blood samples from 15 patients with systemic lupus erythematosus (SLE) and 15 healthy blood donors were allowed to coagulate for one hour at room temperature, followed by one hour at 4 or 37 degrees C. The complement activity of the serum samples was assessed by three different functional assays...

The CD3-zeta chimeric antigen receptor overcomes TCR Hypo-responsiveness of human terminal late-stage T cells.

Directory of Open Access Journals (Sweden)

Gunter Rappl

Full Text Available Adoptive therapy of malignant diseases with tumor-specific cytotoxic T cells showed remarkable efficacy in recent trials. Repetitive T cell receptor (TCR engagement of target antigen, however, inevitably ends up in hypo-responsive cells with terminally differentiated KLRG-1(+ CD57(+ CD7(- phenotype limiting their therapeutic efficacy. We here revealed that hypo-responsiveness of CMV-specific late-stage CD8(+ T cells is due to reduced TCR synapse formation compared to younger cells. Membrane anchoring of TCR components contributes to T cell hypo-responsiveness since dislocation of galectin-3 from the synapse by swainsonine restored both TCR synapse formation and T cell response. Transgenic expression of a CD3-zeta signaling chimeric antigen receptor (CAR recovered hypo-responsive T cells to full effector functions indicating that the defect is restricted to TCR membrane components while synapse formation of the transgenic CAR was not blocked. CAR engineered late-stage T cells released cytokines and mediated redirected cytotoxicity as efficiently as younger effector T cells. Our data provide a rationale for TCR independent, CAR mediated activation in the adoptive cell therapy to avoid hypo-responsiveness of late-stage T cells upon repetitive antigen encounter.

Infrared coagulation versus rubber band ligation in early stage hemorrhoids.

Science.gov (United States)

Gupta, P J

2003-10-01

The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54) or infrared coagulation (N = 46). Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years). The mean duration of disease was 17.5 months (range 12 to 34 months). The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale). Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059). The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03), but also had a higher recurrence or failure rate (P = 0.03). Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

Mechanical ventilation with lower tidal volumes and positive end-expiratory pressure prevents alveolar coagulation in patients without lung injury

NARCIS (Netherlands)

Choi, Goda; Wolthuis, Esther K.; Bresser, Paul; Levi, Marcel; van der Poll, Tom; Dzoljic, Misa; Vroom, Margreeth B.; Schultz, Marcus J.

2006-01-01

BACKGROUND: Alveolar fibrin deposition is a hallmark of acute lung injury, resulting from activation of coagulation and inhibition of fibrinolysis. Previous studies have shown that mechanical ventilation with high tidal volumes may aggravate lung injury in patients with sepsis and acute lung injury.

Dose escalation by hypo fractionation in localized prostate cancer - a large single institution experience

International Nuclear Information System (INIS)

Mahadevan, A.; Klein, E.; Kupelian, P.

2003-01-01

To report the outcomes of high dose radiation therapy using Intensity Modulated Radiation Therapy (IMRT) with hypo fractionation in localized prostate cancer at the Cleveland Clinic Foundation. A total of 278 patients with localized prostate cancer were treated with IMRT between 1998 and 2001. All cases had available pretreatment PSA (iPSA) and biopsy Gleason scores (bGS), no nodal metastasis, a minimum 2 year follow-up, and >5 follow-up PSA levels. The frequency by T-stage was: T1-T2A in 86%, T2B-T2C in 9%, and T3 in 5%. The median iPSA was 8.35. The frequency by bGS was: =7 in 45%. The age range for the patients was from 48 to 85 years (median 68 years). The median follow-up was 33 months (range: 24-49 months). The median doses delivered were 83Gy (delivered at 2.5Gy per fraction to 70 Gy; this being equivalent to 83 Gy at standard fractionation of 1.8 Gy using an alpha/beta of 2). The ASTRO definition for biochemical failure was used. Toxicity was assessed using Radiation Therapy Oncology Group (RTOG) criteria. The 3-year biochemical relapse free survival (bRFS) for the entire cohort at three years was 91%. Any (grade 1 or higher) acute genito-urinary (GU) side effects were seen in 79% of patients. Grade 2 or higher acute GU toxicity was seen in 18% of patients. Any (grade 1 or higher) acute gastro-intestinal (GI) side effects were seen in 65% of patients. Grade 2 or higher acute GI toxicity was seen in 11% of patients. Any (grade 1 or higher) late GU side effects were seen in 3% of patients. Grade 2 or higher late GU toxicity was seen in 1.5% of patients. Any (grade 1 or higher) late GI side effects were seen in 13% of patients. Grade 2 or higher late GI toxicity was seen in 5% of patients. Higher doses of radiation delivered by IMRT resulted in excellent bRFS outcomes in patients with localized prostate cancer receiving external beam radiation therapy. IMRT can be effectively used to safely increase dose delivery without compromising on quality of life

Effect of Continuous Positive Airway Pressure Ventilation on Platelet-activating Factor and Blood Coagulation Function in Patients with Obstructive Sleep Apnea-hypopnea Syndrome

International Nuclear Information System (INIS)

Chen Xiangkun; Sheng Chunyong

2010-01-01

To investigate the effect of continuous positive airway pressure ventilation (CPAP) on platelet-activating factor (PAF) expression and blood coagulation function in patients with obstructive sleep apnea-hypopnea syndrome (OSAS), the blood sample of 40 patients with OSAS were taken before treatment and on the day 30 after treatment respectively. PAF, thromboxane B 2 (TXB2), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrin(FIB) in patients and 37 health controls were detected. The results showed that PAF, TXB2, FIB in OSAS patients before treatment were significantly higher than those of after treatment and control group (P 0.05). There were abnormal expression of PAF and hypercoagulability in OSAS patients. CPAP could effectively decrease the expression of PAF, TXB 2 and could also correct dysfunction of blood coagulation. It had certain effect in lightening the clinical symptoms in OSAS patients. (authors)

Long-term outcomes of ophthalmosurgery in diabetic patients

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Dmitriy Valentinovich Lipatov

2011-03-01

Full Text Available Diabetes morbidity grows steadily despite recent progress in its diagnostics and treatment. Its most frequent complication is retinopathy although thereare increasingly more cases of diabetic cataract, secondary rubeous (neovascular glaucoma, eyelid diseases, and transient impairment of vision.Aim To analyse late results of ophthalmosurgery in diabetic patients with vision problems.Materials and methods Over 24,000 patients were examined from January 2006 to November 2010 at the Department of Diabetic Retinopathyand Ophthalmosurgery, Endocrinological Research Centre. Results of more than 2660 seances of retinal laser coagulation and about 350 surgicalinterventions for diabetic cataract and secondary neovascular glaucoma were available for analysis.Conclusion Timely and correct application of retinal laser coagulation, modern facoemulsification of complicated cataract and drainage surgeryof uncompensated secondary rubeous glaucoma produces good functional results and permits to preserve or even improve visual acuity. The efficacyof surgical intervention is directly related to the quality of diabetes compensation and depends on the joint efforts of ophthalmologists, endocrinologists,and anesthesiologists.

Evaluation of the Diagnostic Performance of Fibrin Monomer in Comparison to d-Dimer in Patients With Overt and Nonovert Disseminated Intravascular Coagulation.

Science.gov (United States)

Singh, Neha; Pati, Hara Prasad; Tyagi, Seema; Upadhyay, Ashish Datt; Saxena, Renu

2017-07-01

Disseminated intravascular coagulation (DIC) is a thrombohemorrhagic disorder characterized by hyperactivation of coagulation and secondary fibrinolysis. The primary aim of this prospective study was to evaluate and compare the diagnostic performance of fibrin monomer (FM) and d-dimer (DD) for the preemptive diagnosis of DIC in the early stages. The patients were categorized into 3 groups: overt DIC, nonovert DIC, and non-DIC based on the International Society of Thrombosis and Hemostasis scoring for overt DIC and the modified nonovert-DIC criteria. Coagulation tests were performed on freshly obtained plasma. Quantitative determination of FM and DD was done by immunoturbidimetric assay. Median DD and FM levels in patients with overt DIC were significantly higher in comparison to the other 2 groups. Interestingly, unlike DD, the difference in FM levels was also found to be statistically significant between patients with nonovert DIC and non-DIC patients ( P = .0001). At receiver-operator characteristic curve-generated cutoff values, FM had higher specificity and negative predictive value than DD for predicting onset of overt DIC. Multivariate analysis showed that only FM was as an independent predictive factor useful in differentiating patients with overt DIC from non-DIC patients (odds ratio [OR]: 43.3; confidence interval [CI] 4.61-406.68; P value = .001) as well as in distinguishing nonovert DIC from non-DIC patients (OR:18.3; CI 3.45-97.19; P value = .001). Fibrin monomer is a better indicator than DD in distinguishing patients with overt and nonovert DIC from non-DIC patients, raising the possibility for its diagnostic utility as a marker for impending overt DIC, aiding in early diagnosis and prompt therapeutic intervention.

Fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation in a patient with diabetes mellitus

Directory of Open Access Journals (Sweden)

Ho Min-Po

2009-01-01

Full Text Available Bacterial meningitis remains a major cause of death and long-term neurologic sequelae worldwide. We present a case of fatal Klebsiella pneumoniae meningitis and concomitant disseminated intravascular coagulation (DIC in a 72-year-old woman with diabetes mellitus (DM. Both blood and cerebrospinal fluid cultures grew Klebsiella pneumoniae . Due to advanced age, newly recognized DM, K. pneumoniae bacteremia, and DIC, the prognosis of our patient was poor. Eight hours after arrival to the emergency department, cardiopulmonary resuscitation was necessary in this patient, but she died despite an early diagnosis and appropriate antibiotic therapy.

Effects of pentastarch and albumin infusion on cardiorespiratory function and coagulation in patients with severe sepsis and systemic hypoperfusion.

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Rackow, E C; Mecher, C; Astiz, M E; Griffel, M; Falk, J L; Weil, M H

1989-05-01

Twenty consecutive patients with severe sepsis were randomized to fluid challenge with 5% albumin or 10% low MW hydroxyethyl starch (pentastarch) solutions. Fluid challenge was administered iv as 250 ml of test colloid every 15 min until the pulmonary artery wedge pressure (WP) was greater than or equal to 15 mm Hg or a maximum dose of 2000 ml was infused. Hemodynamic, respiratory, and coagulation profiles were measured before and after fluid infusion. The amount of colloid required to achieve a WP of 15 mm Hg was comparable between groups. Both colloid infusions resulted in similar increases in cardiac output, stroke output, and stroke work. The effect of fluid infusion with pentastarch on coagulation was not significantly different from albumin, although pentastarch was associated with a 45% decrease in factor VIII:c. We conclude that pentastarch is equivalent to albumin for fluid resuscitation of patients with severe sepsis.

Epsilon aminocaproic acid reduces blood transfusion and improves the coagulation test after pediatric open-heart surgery: a meta-analysis of 5 clinical trials.

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Lu, Jun; Meng, Haoyu; Meng, Zhaoyi; Sun, Ying; Pribis, John P; Zhu, Chunyan; Li, Quan

2015-01-01

Excessive postoperative blood loss after cardiopulmonary bypass is a common problem, especially in patients suffering from congenital heart diseases. The efficacy of epsilon aminocaproic acid (EACA) as a prophylactic treatment for postoperative bleeding after pediatric open-heart surgery has not been determined. This meta-analysis investigates the efficacy of EACA in the minimization of bleeding and blood transfusion and the maintenance of coagulation tests after pediatric open-heart surgery. A comprehensive literature search was performed to identify all randomized clinical trials on the subject. PubMed, Embase, the Cochrane Library, and the Chinese Medical Journal Network were screened. The primary outcome used for the analysis was postoperative blood loss. Secondary outcomes included postoperative blood transfusion, re-exploration rate and postoperative coagulation tests. The mean difference (MD) and risk ratio (RR) with 95% confidence intervals (CI) were used as summary statistics. Five trials were included in this meta-analysis of 515 patients. Prophylactic EACA was associated with a reduction in postoperative blood loss, but this difference did not reach statistical significance (MD: -7.08; 95% CI: -16.11 to 1.95; P = 0.12). Patients treated with EACA received fewer postoperative blood transfusions, including packed red blood cells (MD: -8.36; 95% CI: -12.63 to -4.09; P = 0.0001), fresh frozen plasma (MD: -3.85; 95% CI: -5.63 to -2.08; P open-heart surgery. Prophylactic EACA minimizes postoperative blood transfusion and helps maintain coagulation in pediatric patients undergoing open-heart surgery. Therefore, the results of this study indicate that adjunctive EACA is a good choice for the prevention of postoperative blood transfusion following pediatric cardiac surgery.

Disseminated intravascular coagulation in solid tumors

International Nuclear Information System (INIS)

Terzieff, V.; Alonso, I.; Vázquez, A.

2004-01-01

It is estimated that 20-25% of cases of disseminated intravascular coagulation (DIC) relate to an underlying neoplasia primarily hematologic. It is estimated that about 5% of patients with solid tumors have CID clinic, although the incidence of subclinical alterations is much higher. The CID is not limited to the activation of the coagulation cascade, which leads to bleeding micro thrombosis and consumption of coagulation factors. Solid tumors are frequently associated adenocarcinomas producers mucin (especially gastric), usually in the context of a disseminated disease. The mucin may act as a promoter of the cascade, but probably it is a multi-event. High levels of TNF to produced by the tumor mass and chemotherapy-induced cell lysis have Also linked. Although the bleeding is usually oriented diagnosis, the most frequent cause of death is thrombosis. There are no specific tests for diagnosis. Elevated levels of D-dimer and products oriented fibrinogen degradation diagnosis. No reduction fibrinogen and almost always, one thrombocytopenia consumption. Treatment is complex and there is no consensus on many points. To recover the lost factors for consumption, it is recommended to use fresh frozen plasma and / or washed red blood cells. the heparin anticoagulation low dose is indicated since the disease causal can not be controlled quickly, but should not be initiated if there thrombocytopenia 50.000.El under profuse bleeding can require the use of tranexamic acid or EACA. Acute DIC, the case of our patient, is rare and very serious

Evaluation of the process of coagulation/flocculation of produced water using Moringa oleifera Lam. as natural coagulant

Energy Technology Data Exchange (ETDEWEB)

Santana, C.R.; Pereira, D.F.; Sousa, S.C S N.; Silva, G.F. [Universidade Federal de Sergipe (UFSE), Sao Cristovao, SE (Brazil). Dept. de Engenharia Quimica], e-mail: claudia@ufs.br; Cavalcanti, E.B. [Universidade Tiradentes (UNIT), SE (Brazil). Inst. de Tecnologia e Pesquisa

2010-07-15

In the lifetime of an oil well, there comes a moment when a lot of water begins to be produced along with oil, either by the conditions of the reservoir, or as a result of water injection in the secondary recovery of the well. An important step in such process involves the treatment of the produced water by means of coagulation techniques. Therefore, the use of environmentally correct coagulants is presented as a viable alternative and has demonstrated advantages over the use of chemical coagulants. The plant of the genus Moringa, whose species is oleifera Lam, stands out as one of the most promising natural coagulants. The present study investigated the evaluation of the coagulation/flocculation of produced water, using seeds of Moringa oleifera Lam. as coagulant. The results were very significant, demonstrating that Moringa oleifera Lam. can be used as a natural coagulant in this type of treatment. (author)

Self-production of tissue factor-coagulation factor VII complex by ovarian cancer cells

OpenAIRE

Yokota, N; Koizume, S; Miyagi, E; Hirahara, F; Nakamura, Y; Kikuchi, K; Ruf, W; Sakuma, Y; Tsuchiya, E; Miyagi, Y

2009-01-01

Background: Thromboembolic events are a major complication in ovarian cancer patients. Tissue factor (TF) is frequently overexpressed in ovarian cancer tissue and correlates with intravascular thrombosis. TF binds to coagulation factor VII (fVII), changing it to its active form, fVIIa. This leads to activation of the extrinsic coagulation cascade. fVII is produced by the liver and believed to be supplied from blood plasma at the site of coagulation. However, we recently showed that ovarian ca...

Hypofractionated radiotherapy for the palliation of advanced head and neck cancer in patients unsuitable for curative treatment - 'Hypo Trial'

International Nuclear Information System (INIS)

Porceddu, Sandro V.; Rosser, Brenda; Burmeister, Bryan H.; Jones, Mark; Hickey, Brigid; Baumann, Kacy; Gogna, Kumar; Pullar, Andrew; Poulsen, Michael; Holt, Tanya

2007-01-01

Background and purpose: The primary purpose of the trial was to assess rate of tumour response to a hypofractionated course of radiotherapy in patients with incurable squamous cell carcinoma of the head and neck (HNSCC). Secondary objectives included radiation toxicity, symptom control, quality of life (QoL) and progression-free and overall survival. Patients and methods: Patients were planned to receive 30 Gy in 5 fractions at 2/week, at least 3 days apart, with an additional boost of 6 Gy for small volume disease (≤3 cm) in suitable patients. Thirty-seven patients were enrolled between August 2004 and March 2006. Median age was 68 (43-87) years, 81% were male and the predominant primary site was oropharynx (32%). The majority (73%) presented with Stage III-IV disease. Results: Thirty-five patients received radiotherapy, 1 died prior to treatment and one refused treatment. Of the 35 patients receiving radiotherapy, 31 (88%) received ≥30 Gy. Of the 35 patients who received treatment the overall objective response was 80%. Grade 3 mucositis and dysphagia were experienced in 9/35 (26%) and 4/35 (11%), respectively. QoL and symptom control were assessable in 21 patients. Thirteen (62%) reported an overall improvement in QoL and 14 (67%) experienced an improvement in pain. The median time to progression and death was 3.9 and 6.1 months, respectively. Conclusion: The 'Hypo Trial' regimen provided effective palliative treatment in HNSCC unsuitable for curative treatment. Compliance was excellent and resulted in high response rates, symptom control and improvement in QoL with acceptable toxicity. However, progression free and overall survival was short

Enhanced coagulation for improving coagulation performance and reducing residual aluminum combining polyaluminum chloride with diatomite.

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Hu, Wenchao; Wu, Chunde

2016-01-01

The feasibility of using enhanced coagulation, which combined polyaluminum chloride (PAC) with diatomite for improving coagulation performance and reducing the residual aluminum (Al), was discussed. The effects of PAC and diatomite dosage on the coagulation performance and residual Al were mainly investigated. Results demonstrated that the removal efficiencies of turbidity, dissolved organic carbon (DOC), and UV254 were significantly improved by the enhanced coagulation, compared with PAC coagulation alone. Meaningfully, the five forms of residual Al (total Al (TAl), total dissolved Al (TDAl), dissolved organic Al (DOAl), dissolved monomeric Al (DMAl), and dissolved organic monomeric Al (DOMAl)) all had different degrees of reduction in the presence of diatomite and achieved the lowest concentrations (0.185, 0.06, 0.053, 0.014, and 0 mg L(-1), respectively) at a PAC dose of 15 mg L(-1) and diatomite dose of 40 mg L(-1). In addition, when PAC was used as coagulant, the majority of residual Al existed in dissolved form (about 31.14-70.16%), and the content of DOMAl was small in the DMAl.

Relationship between Inflammation markers, Coagulation Activation and Impaired Insulin Sensitivity in Obese Healthy Women

International Nuclear Information System (INIS)

Soliman, S.Et; Shousha, M.A.

2011-01-01

Obesity, insulin resistance syndrome, and atherosclerosis are closely linked phenomena, often connected with a chronic low grade inflammatory state and pro thrombotic hypo fibrinolytic condition. This study investigated the relationship between impaired insulin sensitivity and selected markers of inflammation and thrombin generation in obese healthy women. The study included 36 healthy obese women (body mass index ≥ 30), with normal insulin sensitivity (NIS, n = 18) or impaired insulin sensitivity (IIS, n 18), and 10 non obese women (body mass index < 25).Impaired insulin sensitivity patients had significantly higher levels of high sensitivity C-reactive protein (hs-CRP), transforming growth factor -β1(TGF-β1), plasminogen activator inhibitor-1 (PAI-1), activated factor VII (VIIa), and prothrombin fragments 1 + 2 (F1 + 2) compared with either control subjects or normal insulin sensitivity patients. On the other hand, NIS patients had higher hs-CRP, TGF-β1, PAI-1, and factor VIIa, but not F1 + 2, levels than controls. Significant inverse correlations were observed between the insulin sensitivity index and TGF-β1, hs-CRP, PAI-1; factor VIIa, and F1 + 2 levels. Moreover, significant direct correlations were noted between TGF-β1 and CRP, PAI-1, factor VIIa, and F1 + 2 concentrations. Finally, multiple regressions revealed that TGF-β1 and the insulin sensitivity index were independently related to F1 + 2. These results document an in vivo relationship between insulin sensitivity and coagulation activation in obesity. Here we report that obesity is associated with higher TGF-β, PAI-1, prothrombin fragments 1 and 2 (F1 + 2), and activated factor VII (VIIa) plasma levels, and that insulin resistance exacerbates these alterations. The elevated TGF-β1 levels detected in the obese population may provide a biochemical link between insulin resistance and an increased risk for cardiovascular disease

Concomitant hypo-hyperdontia: A rare entity

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Yin-Lin Wang

2018-03-01

Full Text Available Background/purpose: Concomitant hypo-hyperdontia (CHH is a rare numeric dental anomaly characterized by congenital missing teeth and supernumerary teeth occurring in the same individual. Due to its rarity and sporadicity, the causes of CHH have been completely unknown. Detailed characterization and presentation of more CHH cases not only strengthen clinical diagnosis and treatment for the patients but facilitate the search for etiological factors of the disorder. Materials and methods: From a pedodontic patient population, 21 CHH subjects, with a mean age of 6 years 10 months, were identified and characterized. Dental records and radiographs were scrutinized and analyzed for the distribution and frequencies of involved teeth and concurrent dental anomalies. Through further literature review, 59 CHH cases with supernumeraries in the premaxillary region were retrieved for comparative analyses. Results: The boys were affected twice as often as the girls. While most cases were unrelated and sporadic, two sisters and a pair of identical twins from two unrelated families were presented. Of all cases, only one was of syndromic CHH carrying Duchenne muscular dystrophy. Bimaxillay CHH, with anomalies involving two jaws, occurred more than 4 times as often as maxillary CHH. While all supernumeraries were found in premaxillary region, hypodontia frequently involved lateral incisors and premolars of both jaws. Conclusion: As genetic contribution to CHH is strongly suggested by its familial occurrence and syndromic cases, environmental factors seem to play certain roles in modifying disease phenotypes. Judicious use of radiographs during early mixed dentition stage enhances clinical diagnosis and treatment of CHH. Keywords: Tooth agenesis, Supernumerary, Numeric anomaly, Premaxillary

Theories of blood coagulation.

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Riddel, James P; Aouizerat, Bradley E; Miaskowski, Christine; Lillicrap, David P

2007-01-01

Although the concept of the coagulation cascade represented a significant advance in the understanding of coagulation and served for many years as a useful model, more recent clinical and experimental observations demonstrate that the cascade/waterfall hypothesis does not fully and completely reflect the events of hemostasis in vivo. The goal of this article is to review the evolution of the theories of coagulation and their proposed models to serve as a tool when reviewing the research and practice literature that was published in the context of these different theories over time.

Infrared coagulation versus rubber band ligation in early stage hemorrhoids

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P.J. Gupta

2003-10-01

Full Text Available The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54 or infrared coagulation (N = 46. Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years. The mean duration of disease was 17.5 months (range 12 to 34 months. The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale. Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059. The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03, but also had a higher recurrence or failure rate (P = 0.03. Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

Retinal venous thrombosis in a young patient with coagulation factor XII deficiency.

Science.gov (United States)

Borrego-Sanz, L; Santos-Bueso, E; Sáenz-Francés, F; Martínez-de-la-Casa, J M; García-Feijoo, J; Gegúndez-Fernández, J A; García-Sánchez, J

2014-08-01

A 35-year-old woman, with no relevant medical history, was referred for sudden vision loss in the left eye. Ophthalmological examination showed best corrected visual acuity of 1.0 in the right eye and 0.3 in left eye, with normal anterior pole and intraocular pressure. Fundus examination of the left eye revealed a venous thrombosis in the superior temporal branch, with dilated and tortuous retinal veins. The patient was referred to the hematology unit for thrombophilia study, and was diagnosed with a coagulation XII or Hageman factor deficiency. The development of retinal vessel occlusions, in patients under 50 years of age, is frequently associated with thrombophilia or hypercoagulability disorders. Factor XII deficiency is a rare condition, and its presence could contribute to a higher risk of thromboembolic events. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

A PK-PD model-based assessment of sugammadex effects on coagulation parameters.

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Bosch, Rolien; van Lierop, Marie-José; de Kam, Pieter-Jan; Kruithof, Annelieke C; Burggraaf, Jacobus; de Greef, Rik; Visser, Sandra A G; Johnson-Levonas, Amy O; Kleijn, Huub-Jan

2016-03-10

Exposure-response analyses of sugammadex on activated partial thromboplastin time (APTT) and prothrombin time international normalized ratio (PT(INR)) were performed using data from two clinical trials in which subjects were co-treated with anti-coagulants, providing a framework to predict these responses in surgical patients on thromboprophylactic doses of low molecular weight or unfractionated heparin. Sugammadex-mediated increases in APTT and PT(INR) were described with a direct effect model, and this relationship was similar in the presence or absence of anti-coagulant therapy in either healthy volunteers or surgical patients. In surgical patients on thromboprophylactic therapy, model-based predictions showed 13.1% and 22.3% increases in respectively APTT and PT(INR) within 30min after administration of 16mg/kg sugammadex. These increases remain below thresholds seen following treatment with standard anti-coagulant therapy and were predicted to be short-lived paralleling the rapid decline in sugammadex plasma concentrations. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Trauma and Coagulation

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Murat Yılmaz

2011-08-01

Full Text Available Bleeding and coagulation disorders related to trauma are pathological processes which are frequently seen and increase mortality. For the purpose, trauma patients should be protected from hypoperfusion, hypothermia, acidosis and hemodilution which may aggravate the increase in physiological responses to trauma as anticoagulation and fibrinolysis. Performing damage control surgery and resuscitation and transfusion of adequate blood and blood products in terms of amount and content as stated in protocols may increase the rate of survival. Medical treatments augmenting fibrin formation (fibrinogen, desmopressin, factor VIIa or preventing fibrin degradation (tranexamic acid have been proposed in selected cases but the efficacy of these agents in trauma patients are not proven. (Journal of the Turkish Society Intensive Care 2011; 9:71-6

Enhanced algae removal by Ti-based coagulant: comparison with conventional Al- and Fe-based coagulants.

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Xu, Jie; Zhao, Yanxia; Gao, Baoyu; Zhao, Qian

2018-05-01

The water eutrophication caused by cyanobacteria seasonally proliferates, which is a hot potato to be resolved for water treatment plants. This study firstly investigated coagulation performance of titanium tetrachloride (TiCl 4 ) for Microcystis aeruginosa synthetic water treatment. Results show complete algal cell removal by TiCl 4 coagulation without damage to cell membrane integrity even under harsh conditions; 60 mg/L TiCl 4 was effective in removing the microcystins up to 85%. Furthermore, besides having stronger UV 254 removal capability and the higher removal of fluorescent substances over Al- and Fe-based coagulants, TiCl 4 coagulant required more compact coagulation and sedimentation tanks due to its significantly improved floc growth and sedimentation speed. Meanwhile, its' short hydraulic retention time avoided algal cell breakage and subsequent algal organic matter release. Microcystin concentrations were kept at a low level during sludge storage period, indicating that the TiCl 4 flocs could prevent algal cells from natural lysis. To facilitate water recycling without secondary contamination, the algae-containing sludge after TiCl 4 coagulation ought to be disposed within 12 days at 20 °C and 8 days at 35 °C.

The interplay between platelets and coagulation

NARCIS (Netherlands)

Weeterings, C.

2009-01-01

Platelet activation and blood coagulation are two processes often studied separately, but which cannot be seen independently from each other. Platelets play a pivotal role in coagulation, not only by providing negatively charged phospholipids, but also in localizing the coagulation process from a

Quantifying rainfall-runoff relationships on the Mieso Hypo Calcic ...

African Journals Online (AJOL)

The mean annual rainfall at Mieso is 738 mm. The soil is a Hypo Calcic Vertisol with a high clay and silt content and is very susceptible to crusting. To achieve the objective of the study, rainfall-runoff measurements were made during 2003 and 2004 on 2 m x 2 m plots provided with a runoff measuring system, and replicated ...

Prehospital resuscitation with hypertonic saline-dextran modulates inflammatory, coagulation and endothelial activation marker profiles in severe traumatic brain injured patients

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Morrison Laurie J

2010-01-01

Full Text Available Abstract Background Traumatic brain injury (TBI initiates interrelated inflammatory and coagulation cascades characterized by wide-spread cellular activation, induction of leukocyte and endothelial cell adhesion molecules and release of soluble pro/antiinflammatory cytokines and thrombotic mediators. Resuscitative care is focused on optimizing cerebral perfusion and reducing secondary injury processes. Hypertonic saline is an effective osmotherapeutic agent for the treatment of intracranial hypertension and has immunomodulatory properties that may confer neuroprotection. This study examined the impact of hypertonic fluids on inflammatory/coagulation cascades in isolated head injury. Methods Using a prospective, randomized controlled trial we investigated the impact of prehospital resuscitation of severe TBI (GCS vs 0.9% normal saline (NS, on selected cellular and soluble inflammatory/coagulation markers. Serial blood samples were drawn from 65 patients (30 HSD, 35 NS at the time of hospital admission and at 12, 24, and 48-h post-resuscitation. Flow cytometry was used to analyze leukocyte cell-surface adhesion (CD62L, CD11b and degranulation (CD63, CD66b molecules. Circulating concentrations of soluble (sL- and sE-selectins (sL-, sE-selectins, vascular and intercellular adhesion molecules (sVCAM-1, sICAM-1, pro/antiinflammatory cytokines [tumor necrosis factor (TNF-α and interleukin (IL-10], tissue factor (sTF, thrombomodulin (sTM and D-dimers (D-D were assessed by enzyme immunoassay. Twenty-five healthy subjects were studied as a control group. Results TBI provoked marked alterations in a majority of the inflammatory/coagulation markers assessed in all patients. Relative to control, NS patients showed up to a 2-fold higher surface expression of CD62L, CD11b and CD66b on polymorphonuclear neutrophils (PMNs and monocytes that persisted for 48-h. HSD blunted the expression of these cell-surface activation/adhesion molecules at all time-points to

[Haplotype Analysis of Coagulation Factor VII Gene in a Patient with Congenital Coagulation Factor VII Deficiency with Heterozygous p.Arg337Cys Mutation and o.Aro413Gin Polymorphism..

Science.gov (United States)

Suzuki, Keijiro; Yoshioka, Tomoko; Obara, Takehiro; Suwabe, Akira

2016-05-01

Congenital coagulation factor VII (FVII) deficiency is a rare hemorrhagic disease with an autosomal reces- sive inheritance pattern. We analyzed coagulation factor VII gene (F7) of a patient with FVII deficiency and used expression studies to investigate the effect of a missense mutation on FVII secretion. The proband, a 69-year-old Japanese woman, had a history of postpartum bleeding and excessive bleeding after dental extrac- tion. She was found to have mildly increased PT-INR (1.17) before an ophthalmic operation. FVII activity and antigen were reduced (29.0% and 32.8%). Suspecting that the proband was FVII deficient, we analyzed F7 of the patient. Sequence analysis revealed that the patient was heterozygous for a point mutation (p.Arg337Cys) in the catalytic domain and polymorphisms: the decanucleotide insertion at the promoter re- gion, dimorphism (c.525C >T) in exon 5, and p.Arg413Gln in exon 8. Haplotype analysis clarified that p.Arg337Cys was located on the p.Arg413 allele (Ml allele). The other allele had the p.Arg413Gln polymor- phism(M2 allele) which is known to produce less FVII. Expression studies revealed that p.Arg337Cys causes impairment of FVII secretion. Insufficient secretion of FVII arising from both the p.Arg337Cys/M1 allele and the p.Arg337/M2 allele might lower the FVII level of this patient(<50%). The FVII level in a heterozygous FVII deficient patient might be influenced by F7 polymorphisms on the normal allele. There- fore, genetic analyses are important for the diagnosis of heterozygous FVII deficiency.

Dust coagulation in ISM

Science.gov (United States)

Chokshi, Arati; Tielens, Alexander G. G. M.; Hollenbach, David

1989-01-01

Coagulation is an important mechanism in the growth of interstellar and interplanetary dust particles. The microphysics of the coagulation process was theoretically analyzed as a function of the physical properties of the coagulating grains, i.e., their size, relative velocities, temperature, elastic properties, and the van der Waal interaction. Numerical calculations of collisions between linear chains provide the wave energy in individual particles and the spectrum of the mechanical vibrations set up in colliding particles. Sticking probabilities are then calculated using simple estimates for elastic deformation energies and for the attenuation of the wave energy due to absorption and scattering processes.

[Application of electric coagulation treatment via bronchoscopy in the management of congenital vallecular cyst in children].

Science.gov (United States)

Liu, Xia; Ma, Jing; Zhao, Feng-mei; Zhang, Zhong-xiao; Niu, Tie-huan; Yan, Xiu-li; Wang, Chao; Meng, Chen

2013-11-01

To discuss the effect of electric coagulation through bronchoscopy in diagnosis and treatment of congenital vallecular cyst in children. Ten cases of congenital vallecular cyst in the study with age ranged from 21 days to 4 years and 10 months were treated with electric coagulation through bronchoscopy. The therapeutic effect was evaluated by endoscopic and clinical manifestation. And all the patients were followed-up for 6-12 months. All the patients obtained 3-5 times electric coagulation. After the operation, the cyst decreased in size, epiglottis softening was subsided, uplift uncompression, dyspnea and laryngeal stridor were improved obviously. After follow-up periods of 6-12 months, no capsule wall were left, and the activity of the epiglottis resumed.No severe complication was found in any patient. Electric coagulation through bronchoscopy is a simple, effective and safe method to treat congenital vallecular cyst in children.

Blood coagulation parameters and activity indices in patients with systemic lupus erythematosus

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A. A. Arshinov

2005-01-01

Full Text Available Objective. To assess coagulation parameters and activity indices in pts with systemic lupus erythematosus (SLE. Material and methods . 86 pts with SLE (83 female and 3 male were examined. 12 of them had antiphospholipid syndrome. Mean age was 35,9±1,5 years (from 18 to 58 years, mean disease duration was 9,8+1,4 years. Control group consisted of 60 healthy volunteers with mean age 37,1+4,1 years. SLE activity assessment was performed with SLAM, SLEDAI and ECLAM indices. Results. SLE pts showed 5-fold (p<0,01 increase of spontaneous platelets aggregation and more than 3-fold increase of factor von Willebrand antigen (FWA concentration. Platelet activation in pts was accompanied by decrease of platelet aggregation with collagen (on 27%, p<0,01. Characteristic sign of coagulation hemostasis activation was significant increase of soluble fibrin-monomer complexes (SFMC concentration on 81 % (p<0,01 so as increase D-dimers level in 53,3% of pts. Fibrinogen concentration was increased on 29%, spontaneous fibrinolysis parameters were decreased on 20%, antithrombin (AT 111 - on 21% in comparison with control. Direct correlation between activity indiccs and SFMC(ECLAM, r=0,5, fibrinogen concentration (SLAM, r=0,34, D- dimers level (ECLAM, r=0,5, spontaneous platelet aggregation (ECLAM, r=0,5 so as inverse correlation with AT III activity (SLEDAI, r-0,73 was revealed. Conclusion. Changes of hemostasis parameters in SLE may serve as predictors of thrombotic disorders development and indication to drug correction of blood coagulation disorders. Direct correlation between blood coagulation system activity and indices of SLE activity.

Ambient hemolysis and activation of coagulation is different between HeartMate II and HeartWare left ventricular assist devices.

Science.gov (United States)

Birschmann, Ingvild; Dittrich, Marcus; Eller, Thomas; Wiegmann, Bettina; Reininger, Armin J; Budde, Ulrich; Strüber, Martin

2014-01-01

Thromboembolic and bleeding events in patients with a left ventricular assist device (LVAD) are still a major cause of complications. Therefore, the balance between anti-coagulant and pro-coagulant factors needs to be tightly controlled. The principle hypothesis of this study is that different pump designs may have an effect on hemolysis and activation of the coagulation system. Referring to this, the HeartMate II (HMII; Thoratec Corp, Pleasanton, CA) and the HeartWare HVAD (HeartWare International Inc, Framingham, MA) were investigated. For 20 patients with LVAD support (n = 10 each), plasma coagulation, full blood count, and clinical chemistry parameters were measured. Platelet function was monitored using platelet aggregometry, platelet function analyzer-100 system ( Siemens, Marburg, Germany), vasodilator-stimulated phosphoprotein phosphorylation assay, immature platelet fraction, platelet-derived microparticles, and von Willebrand diagnostic. Acquired von Willebrand syndrome could be detected in all patients. Signs of hemolysis, as measured by lactate dehydrogenase levels (mean, 470 U/liter HMII, 250 U/liter HVAD; p < 0.001), were more pronounced in the HMII patients. In contrast, D-dimer analysis indicated a significantly higher activation of the coagulation system in HVAD patients (mean, 0.94 mg/liter HMII, 2.01 mg/liter HVAD; p < 0.01). The efficacy of anti-platelet therapy using clopidogrel was not sufficient in more than 50% of the patients. Our results support the finding that all patients with rotary blood pumps suffered from von Willebrand syndrome. In addition, a distinct footprint of effects on hemolysis and the coagulation system can be attributed to different devices. As a consequence, the individual status of the coagulation system needs to be controlled in long-term patients. © 2013 Published by International Society for the Heart and Lung Transplantation on behalf of International Society for Heart and Lung Transplantation.

Removal Natural Organic Matter (NOM in Peat Water from Wetland Area by Coagulation-Ultrafiltration Hybrid Process with Pretreatment Two-Stage Coagulation

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Mahmud Mahmud

2016-06-01

Full Text Available The primary problem encountered in the application of membrane technology was membrane fouling. During this time, hybrid process by coagulation-ultrafiltration in drinking water treatment that has been conducted by some research, using by one-stage coagulation. The goal of this research was to investigate the effect of two-stage coagulation as a pretreatment towards performance of the coagulation-ultrafiltration hybrid process for removal NOM in the peat water. Coagulation process, either with the one-stage or two-stage coagulation was very good in removing charge hydrophilic fraction, i.e. more than 98%. NOM fractions of the peat water, from the most easily removed by the two-stage coagulation and one-stage coagulation process was charged hydrophilic>strongly hydrophobic>weakly hydrophobic>neutral hydrophilic. The two-stage coagulation process could removed UV254 and colors with a little better than the one-stage coagulation at the optimum coagulant dose. Neutral hydrophilic fraction of peat water NOM was the most influential fraction of UF membrane fouling. The two-stage coagulation process better in removing the neutral hidrophilic fraction, while removing of the charged hydrophilic, strongly hydrophobic and weakly hydrophobic similar to the one-stage coagulation. Hybrid process by pretreatment with two-stage coagulation, beside can increased removal efficiency of UV254 and color, also can reduced fouling rate of the ultrafiltration membraneIt must not exceed 250 words, contains a brief summary of the text, covering the whole manuscript without being too elaborate on every section. Avoid any abbreviation, unless it is a common knowledge or has been previously stated.

Removal Natural Organic Matter (NOM in Peat Water from Wetland Area by Coagulation-Ultrafiltration Hybrid Process with Pretreatment Two-Stage Coagulation

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Mahmud Mahmud

2013-11-01

Full Text Available The primary problem encountered in the application of membrane technology was membrane fouling. During this time, hybrid process by coagulation-ultrafiltration in drinking water treatment that has been conducted by some research, using by one-stage coagulation. The goal of this research was to investigate the effect of two-stage coagulation as a pretreatment towards performance of the coagulation-ultrafiltration hybrid process for removal NOM in the peat water. Coagulation process, either with the one-stage or two-stage coagulation was very good in removing charge hydrophilic fraction, i.e. more than 98%. NOM fractions of the peat water, from the most easily removed by the two-stage coagulation and one-stage coagulation process was charged hydrophilic>strongly hydrophobic>weakly hydrophobic>neutral hydrophilic. The two-stage coagulation process could removed UV254 and colors with a little better than the one-stage coagulation at the optimum coagulant dose. Neutral hydrophilic fraction of peat water NOM was the most influential fraction of UF membrane fouling. The two-stage coagulation process better in removing the neutral hidrophilic fraction, while removing of the charged hydrophilic, strongly hydrophobic and weakly hydrophobic similar to the one-stage coagulation. Hybrid process by pretreatment with two-stage coagulation, beside can increased removal efficiency of UV254 and color, also can reduced fouling rate of the ultrafiltration membraneIt must not exceed 250 words, contains a brief summary of the text, covering the whole manuscript without being too elaborate on every section. Avoid any abbreviation, unless it is a common knowledge or has been previously stated.

Hypo-fractionated treatment in radiotherapy: radio-biological models Tcp and NTCP

International Nuclear Information System (INIS)

Astudillo V, A. J.; Mitsoura, E.; Paredes G, L.; Resendiz G, G.

2014-08-01

At the present time the breast cancer in Mexico has the first place of incidence of the malignant neoplasia s in the women, and represents 11.34% of all the cancer cases. On the other hand, the treatments for cancer by means of ionizing radiations have been dominated under the approaches of the medical radio-oncologists which have been based on test and error by many years. The radio-biological models, as the Tcp, NTCP and dosimetric variables, for their clinical application in the conventional radiotherapy with hypo-fractionation have as purpose predicting personalized treatment plans that they present most probability of tumor control and minor probability of late reactions, becoming this way support tools in the decisions taking for the patient treatments planning of Medical Physicists and Radio-oncologists. (Author)

Norm- and hypo-fractionated radiotherapy is capable of activating human dendritic cells.

Science.gov (United States)

Kulzer, Lorenz; Rubner, Yvonne; Deloch, Lisa; Allgäuer, Andrea; Frey, Benjamin; Fietkau, Rainer; Dörrie, Jan; Schaft, Niels; Gaipl, Udo S

2014-10-01

Despite the transient immunosuppressive properties of local radiotherapy (RT), this classical treatment modality of solid tumors is capable of inducing immunostimulatory forms of tumor-cell death. The resulting 'immunotoxicity' in the tumor, but not in healthy tissues, may finally lead to immune-mediated destruction of the tumor. However, little is known about the best irradiation scheme in this setting. This study examines the immunological effects of differently irradiated human colorectal tumor cells on human monocyte-derived dendritic cells (DC). Human SW480 tumor cells were irradiated with a norm-fractionation scheme (5 × 2 Gy), a hypo-fractionated protocol (3 × 5 Gy), and with a high single irradiation dose (radiosurgery; 1 × 15 Gy). Subsequently, human immature DC (iDC) were co-incubated with supernatants (SN) of these differently treated tumor cells. Afterwards, DC were analyzed regarding the expression of maturation markers, the release of cytokines, and the potential to stimulate CD4(+) T-cells. The co-incubation of iDC with SN of tumor cells exposed to norm- or hypo-fractionated RT resulted in a significantly increased secretion of the immune activating cytokines IL-12p70, IL-8, IL-6, and TNFα, compared to iDC co-incubated with SN of tumor cells that received a high single irradiation dose or were not irradiated. In addition, DC-maturation markers CD80, CD83, and CD25 were also exclusively elevated after co-incubation with the SN of fractionated irradiated tumor cells. Furthermore, the SN of tumor cells that were irradiated with norm- or hypo-fractionated RT triggered iDC to stimulate CD4(+) T-cells not only in an allogenic, but also in an antigen-specific manner like mature DC. Collectively, these results demonstrate that norm- and hypo-fractionated RT induces a fast human colorectal tumor-cell death with immunogenic potential that can trigger DC maturation and activation in vitro. Such findings may contribute to the improvement of

Addition of Arsenic Trioxide into Induction Regimens Could Not Accelerate Recovery of Abnormality of Coagulation and Fibrinolysis in Patients with Acute Promyelocytic Leukemia.

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Ye Zhang

Full Text Available All-trans retinoic acid combined to anthracycline-based chemotherapy is the standard regimen of acute promyelocytic leukemia. The advent of arsenic trioxide has contributed to improve the anti-leukemic efficacy in acute promyelocytic leukemia. The objectives of the current study were to evaluate if dual induction by all-trans retinoic acid and arsenic trioxide could accelerate the recovery of abnormality of coagulation and fibrinolysis in patients with acute promyelocytic leukemia.Retrospective analysis was performed in 103 newly-diagnosed patients with acute promyelocytic leukemia. Hemostatic variables and the consumption of component blood were comparably analyzed among patients treated by different induction regimen with or without arsenic trioxide.Compared to patients with other subtypes of de novo acute myeloid leukemia, patients with acute promyelocytic leukemia had lower platelet counts and fibrinogen levels, significantly prolonged prothrombin time and elevated D-dimers (P<0.001. Acute promyelocytic leukemia patients with high or intermediate risk prognostic stratification presented lower initial fibrinogen level than that of low-risk group (P<0.05. After induction treatment, abnormal coagulation and fibrinolysis of patients with acute promyelocytic leukemia was significantly improved before day 10. The recovery of abnormal hemostatic variables (platelet, prothrombin time, fibrinogen and D-dimer was not significantly accelerated after adding arsenic trioxide in induction regimens; and the consumption of transfused component blood (platelet and plasma did not dramatically change either. Acute promyelocytic leukemia patients with high or intermediate risk prognostic stratification had higher platelet transfusion demands than that of low-risk group (P<0.05.Unexpectedly, adding arsenic trioxide could not accelerate the recovery of abnormality of coagulation and fibrinolysis in acute promyelocytic leukemia patients who received all

Nitric oxide and thyroid hormone receptor alpha 1 contribute to ovarian follicular development in immature hyper- and hypo-thyroid rats.

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Zheng, Kaizhi; Sulieman, Fedail Jaafar; Li, Junrong; Wei, Quanwei; Xu, Mulin; Shi, Fangxiong

2015-03-01

Thyroid dysfunction can cause ovarian cycle and ovulatory disturbances, however, the molecular link(s) between these two disorders remains largely unknown. In the current study, we examined the roles of nitric oxide synthase (NOS) and thyroid hormone receptor alpha 1 (TRα1) in these disorders using immature hyper-thyroid (hyper-T) and hypo-thyroid (hypo-T) rats. In comparison to controls, hyper-T rats had higher serum concentrations of triiodothyronine (T3) and thyroxine (T4), whereas hypo-T rats had lower serum T3 and T4. Serum estradiol (E2) level was decreased in both hyper-T and hypo-T animals and serum E2 in hyper-T rats were lower than in hypo-T rats. We found that neuronal NOS (nNOS) and TRα1 were present in oocytes, granulosa cells and theca cells of all examined rat groups. Ovarian nitric oxide (NO) content and the constitutive NOS (cNOS) activity in hyper-T rats were significantly decreased compared with control or hypo-T rats. Moreover, the number of large antral follicles was reduced in hyper-T rats, and number of primordial follicles was decreased in hypo-T rats compared with control rats. In conclusion, we observed an association between thyroid hormone and NO signaling pathways during the process of ovarian follicular development in immature rats. In hyperthyroidism, thyroid hormones induced an estrogen deficiency that inhibited the function of nNOS, resulting in the inhibition of NO synthesis and suppressed development of large antral follicles, while in hypothyroidism only development of primordial follicles was inhibited. Copyright © 2014 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Short-term effects of air pollution, markers of endothelial activation, and coagulation to predict major adverse cardiovascular events in patients with acute coronary syndrome: insights from AIRACOS study.

Science.gov (United States)

Dominguez-Rodriguez, Alberto; Abreu-Gonzalez, Pedro; Rodríguez, Sergio; Avanzas, Pablo; Juarez-Prera, Ruben A

2017-07-01

The aim of this study was to determine whether markers of inflammation and coagulation are associated with short-term particulate matter exposure and predict major adverse cardiovascular events at 360 d in patients with acute coronary syndrome (ACS). We included 307 consecutive patients, and assessed the average concentrations of data on atmospheric pollution in ambient air and meteorological variables from 1 d up to 7 d prior to admission. In patients with ACS, the markers of endothelial activation and coagulation, but not black carbon exposure, are associated with major adverse cardiovascular events at one-year follow-up.

Impact of Albumin on Coagulation Competence and Hemorrhage During Major Surgery

DEFF Research Database (Denmark)

Rasmussen, Kirsten C; Højskov, Michael; Johansson, Pär I.

2016-01-01

trial evaluates whether administration of 5% human albumin (HA) or lactated Ringer solution (LR) affects coagulation competence and in turn blood loss during cystectomy due to bladder cancer. Forty patients undergoing radical cystectomy were included to receive either 5% HA (n = 20) or LR (n = 20......). Nineteen patients were analyzed in the HA group and 20 patients in the lactated Ringer group. Blinded determination of the blood loss was similar in the 2 groups of patients: 1658 (800-3300) mL with the use of HA and 1472 (700-4330) mL in the lactated Ringer group (P = 0.45). Yet, by thrombelastography...... (TEG) evaluated coagulation competence, albumin affected clot growth (TEG-angle 69 ± 5 vs 74° ± 3°, P 

Endoscopic Therapy of Refractory Post-Papillotomy Bleeding With Electrocautery Forceps Coagulation Method Combined With Prophylactic Pancreatic Stenting

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Zsolt Dubravcsik

2014-01-01

Conclusion: We presented a new, effective and safe second line endoscopic hemostatic method in patients with therapy resistant post-papillotomy bleeding. Combination of prophylactic pancreatic stenting and thermal coagulation with coagulation forceps might be suggested as a rescue treatment in patients with severe post-papillotomy bleeding, resistant to standard endoscopic therapy.

TRAITEMENT DES EAUX USEES PAR COAGULATION-FLOCULATION EN UTILISANT LE SULFATE D’ALUMINIUM COMME COAGULANT

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Nora SEGHAIRI

2017-12-01

Full Text Available Domestic wastewater treatment by coagulation-flocculation is widely used internationally. This treatment reduces color and turbidity, indicating organic and inorganic contaminants, but at acceptable levels for treated waste water discharged into the receiving environment. The objective of this study is to optimize the treatment of wastewater by coagulation-flocculation using aluminum sulphate as a coagulant. Various reaction parameters are taken into account, such as the coagulant dose, the pH of the solutions, the conductivity, the BOD5, the nitrates, the ammonium and the phosphates. We found from the different results obtained the optimal dose of aluminum sulphate is 400 mg/l with a reduction of 96.31%, 82.44% 90.95% and 78.74% respectively for phosphates, nitrates, ammonium and BOD5. It is recognized that pH influences the abatement rates of pollution contained in wastewater. For each water, there is a pH range for which coagulation- flocculation takes place rapidly. For our study, the optimum pH for removal of BOD5 and ammonium is between 6 and 7.

Efficacy and toxicity of conventionally fractionated pelvic radiation with a hypo fractionated simultaneous versus conventionally fractionated sequential boost for patients with high-risk prostate cancer

International Nuclear Information System (INIS)

McDonald, Andrew M.; Jacob, Rojymon; Dobelbower, Michael C.; Kim, Robert Y.; Fiveash, John B.

2013-01-01

Purpose: To determine if high-risk prostate cancer responds differently to hypo fractionation. Material and methods: One hundred and fifty-seven men with NCCN high-risk (T3, PSA 20, or Gleason 8) clinically localized prostate cancer treated between 1998 and 2010 met the inclusion criteria for the analysis. Eighty-two were treated with conventional WPRT with a conventionally fractionated sequential boost to the prostate (cRT), with the prostate receiving 75-77 Gy in 1.8 - 2.0 Gy fractions. Seventy-five were treated with pelvic IMRT with a hypo fractionated simultaneous boost to the prostate (hRT), with the prostate receiving 70 Gy in 2.5 Gy fractions. The dose to the pelvic lymph nodes was 45 Gy in the cRT group and 50.4 Gy in the hRT group, both at 1.8 Gy per fraction. Ninety-two percent received neoadjuvant hormonal ablation therapy, typically beginning two months prior to the start of RT. Results: Median follow-up was 6.5 years for men receiving cRT and 3.7 years for those receiving hRT. The actuarial rate of biochemical control at four years was 88% for cRT and 94% for hRT (p=0.82). The rates of early rectal and urinary grade ≥2 toxicities were 35% (29 of 82) and 49% (40 of 82) for the cRT group and 36% (27 of 75) and 44% (33 of 75) for the hRT group. The actuarial rate of late grade 2 rectal toxicity at four years was 25% for the cRT group and 13% for the hRT group (p=0.037). The rate of late grade 3 rectal complications was 4% (3 of 82) for patients receiving cRT and 1% (1 of 75) for patients receiving hRT. Conclusion: Initial follow-up indicates equivalent biochemical control between regimens. Patients receiving hRT experienced fewer late rectal complications

Hypo-fractionated radiotherapy of breast cancer: long term results of a set of 80 cases treated in the radiotherapy department of the Oran university hospital

International Nuclear Information System (INIS)

Boukerche, A.; Yahia, A.; Madouri, R.; Belmiloud, H.; Dali-Youcef, A.F.

2011-01-01

The authors report the assessment of the local and locoregional control and of the acute and late toxicity of adjuvant hypo-fractionated radiotherapy in breast cancer treatment. During 1998, 80 women have been treated by conservative or radical surgery and hypo-fractionated tele-cobalto-therapy (36 Gy in five fractions of 3 Gy a week, and a boost of 15 Gy in five fractions in case of conservative surgery). Results are discussed in terms of local and locoregional recurrence, tolerance, late toxicity, global survival, and tumour classification. The irradiation scheme seems perfectly achievable but a greater number of patients and a longer follow-up are required to better assess the efficiency and aesthetic results. Short communication

Microwave tissue coagulation: effects of power and treatment time on coagulation size

International Nuclear Information System (INIS)

Kang, Seung Pyung; Kim, Young Hwan; Park, Dong Man; Kim, Jeong Seok; Park, Seo Young; Cha, Soon Joo; Hur, Gham

1999-01-01

To determine the effects of power and coagulation time on lesion size of ex-vivo bovine liver using microwaves. Six bovine livers were divided into two groups (first group : 30W output, second group : 60W output) and microwave coagulation was performed for 30, 60, and 120 sec. Thermal injury site was then observed by means of sonography, and the maximal transverse diameter of the echo-change portion after microwave coagulation was measured. On the section of specimen, maximal transverse diameters of the thermal injury site were measured by gross inspection and compared with the result of sonographic measurement. Maximal transverse diameters of hyperechoic lesions of the first group, as seen on sonography, were 8.3mm, 12.2mm, and 15.6mm, and the maximal transverse diameters of thermal injury sites on gross specimens were 9.1mm, 12.0mm, and 15.1mm, respectively. Maximal transverse diameters of hyperechoic lesions of the second group, as seen on sonography, were 12.1mm, 17.4mm, and 21.2mm and maximal transverse diameters of thermal injury sites on gross specimens were 13.2mm, 16.0mm, and 20.0mm, respectively. Statistically maximal transverse diameters of hyperechoic lesions, as seen on sonography, correlated closely with the gross findings of maximal transverse diameters of thermal injury sites (P < .05). Maximal transverse diameters of thermal injury sites were significantly increased as the output of the microwave coagulator and the duration of coagulation time increased (P < .05)

Should anti-inhibitor coagulant complex and tranexamic acid be used concomitantly?

Science.gov (United States)

Valentino, L A; Holme, P A

2015-11-01

Inhibitor development in haemophilia patients is challenging especially when undergoing surgical procedures. The development of an inhibitor precludes using factor VIII (FVIII) therapy thereby requiring a bypassing agent (BPA) for surgical bleeding prophylaxis if the FVIII inhibitor titre >5 BU. Concomitant use of anti-inhibitor coagulant complex (AICC) and tranexamic acid has been reported in the literature as a beneficial treatment for this population. Anti-inhibitor coagulant complex is known to cause an increase in thrombin generation and tranexamic acid inhibits fibrinolysis. Hence, the combined used of AICC and tranexamic acid has been limited due to safety concerns over possibilities of increased risk of thrombotic events and disseminated intravascular coagulation. However, the rationale for concomitant therapy is to obtain a potential synergistic effect and to increase clot stability. We conducted a literature review of past studies and individual case reports of concomitant use of AICC and tranexamic acid, which was extensively used during dental procedures. Evidence also exists for concomitant use of the combined therapy in orthopaedic procedures, control of gastrointestinal bleeding, epistaxis and cerebral haemorrhages. Some patients who received the combined therapy had failed monotherapy with a single BPA prior to combined therapy. There were no reports of thrombotic complications related to the concomitant therapy and haemostasis was achieved in all cases. Anti-inhibitor coagulant complex and tranexamic acid therapy was found to be safe, well-tolerated and effective therapy in haemophilia patients with inhibitors. Additional randomized controlled studies should be performed to confirm these findings. © 2015 John Wiley & Sons Ltd.

Emergent self-similarity of cluster coagulation

Science.gov (United States)

Pushkin, Dmtiri O.

A wide variety of nonequilibrium processes, such as coagulation of colloidal particles, aggregation of bacteria into colonies, coalescence of rain drops, bond formation between polymerization sites, and formation of planetesimals, fall under the rubric of cluster coagulation. We predict emergence of self-similar behavior in such systems when they are 'forced' by an external source of the smallest particles. The corresponding self-similar coagulation spectra prove to be power laws. Starting from the classical Smoluchowski coagulation equation, we identify the conditions required for emergence of self-similarity and show that the power-law exponent value for a particular coagulation mechanism depends on the homogeneity index of the corresponding coagulation kernel only. Next, we consider the current wave of mergers of large American banks as an 'unorthodox' application of coagulation theory. We predict that the bank size distribution has propensity to become a power law, and verify our prediction in a statistical study of the available economical data. We conclude this chapter by discussing economically significant phenomenon of capital condensation and predicting emergence of power-law distributions in other economical and social data. Finally, we turn to apparent semblance between cluster coagulation and turbulence and conclude that it is not accidental: both of these processes are instances of nonlinear cascades. This class of processes also includes river network formation models, certain force-chain models in granular mechanics, fragmentation due to collisional cascades, percolation, and growing random networks. We characterize a particular cascade by three indicies and show that the resulting power-law spectrum exponent depends on the indicies values only. The ensuing algebraic formula is remarkable for its simplicity.

Coagulation effectiveness of graphene oxide for the removal of turbidity from raw surface water.

Science.gov (United States)

Aboubaraka, Abdelmeguid E; Aboelfetoh, Eman F; Ebeid, El-Zeiny M

2017-08-01

This study presents the performance of graphene oxide (GO) as a coagulant in turbidity removal from naturally and artificially turbid raw surface water. GO is considered an excellent alternative to alum, the more common coagulant used in water treatment processes, to reduce the environmental release of aluminum. Effects of GO dosage, pH, and temperature on its coagulation ability were studied to determine the ideal turbidity removal conditions. The turbidity removal was ≥95% for all levels of turbid raw surface water (20, 100, and 200 NTU) at optimum conditions. The role of alkalinity in inducing turbidity removal by GO coagulation was much more pronounced upon using raw surface water samples compared with that using artificially turbid deionized water samples. Moreover, GO demonstrated high-performance removal of biological contaminants such as algae, heterotrophic bacteria, and fecal coliform bacteria by 99.0%, 98.8% and 96.0%, respectively, at a dosage of 40 mg/L. Concerning the possible environmental release of GO into the treated water following filtration process, there was no residual GO in a wide range of pH values. The outcomes of the study highlight the excellent coagulation performance of GO for the removal of turbidity and biological contaminants from raw surface water. Copyright © 2017 Elsevier Ltd. All rights reserved.

The variation field of the radiosensitivity in the human population: hypersensitivity and hypo sensitivity

International Nuclear Information System (INIS)

Bouffler, S.

2009-01-01

It is generally admitted in the radiotherapy practice that 5% of patients will present serious reactions of normal tissues. Studies made on human population confirm it exists variations of cell radiosensitivity and genetic factors contribute in a significant manner to the observed variations. The researches of markers able to predict the reactions of normal tissues to the therapy focussed on the identification of sensitive sub-group. It is however obvious that exists also a part of the population relatively hypo sensitive. It would be interesting to make studies on the genome to find genes associated to serious reactions of normal tissues to radiotherapy. (N.C.)

Population pharmacokinetics of recombinant coagulation factor VIII-SingleChain in patients with severe hemophilia A.

Science.gov (United States)

Zhang, Y; Roberts, J; Tortorici, M; Veldman, A; St Ledger, K; Feussner, A; Sidhu, J

2017-06-01

Essentials rVIII-SingleChain is a unique recombinant factor VIII (FVIII) molecule. A population pharmacokinetic model was based on FVIII activity of severe hemophilia A patients. The model was used to simulate factor VIII activity-time profiles for various dosing scenarios. The model supports prolonged dosing of rVIII-SingleChain with intervals of up to twice per week. Background Single-chain recombinant coagulation factor VIII (rVIII-SingleChain) is a unique recombinant coagulation factor VIII molecule. Objectives To: (i) characterize the population pharmacokinetics (PK) of rVIII-SingleChain in patients with severe hemophilia A; (ii) identify correlates of variability in rVIII-SingleChain PK; and (iii) simulate various dosing scenarios of rVIII-SingleChain. Patients/Methods A population PK model was developed, based on FVIII activity levels of 130 patients with severe hemophilia A (n = 91 for ≥ 12-65 years; n = 39 for  85% and > 93% of patients were predicted to maintain FVIII activity level above 1 IU dL -1 , at all times with three-times-weekly dosing (given on days 0, 2, and 4.5) at the lowest (20 IU kg -1 ) and highest (50 IU kg -1 ) doses, respectively. For twice weekly dosing (days 0 and 3.5) of 50 IU kg -1 rVIII-SingleChain, 62-80% of patients across all ages were predicted to maintain a FVIII activity level above 1 IU dL -1 at day 7. Conclusions The population PK model adequately characterized rVIII-SingleChain PK, and the model can be utilized to simulate FVIII activity-time profiles for various dosing scenarios. © 2017 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals, Inc. on behalf of International Society on Thrombosis and Haemostasis.

Enhanced WWTP effluent organic matter removal in hybrid ozonation-coagulation (HOC) process catalyzed by Al-based coagulant

Energy Technology Data Exchange (ETDEWEB)

Jin, Xin [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Jin, Pengkang, E-mail: pkjin@hotmail.com [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Hou, Rui [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China); Yang, Lei [Department of Materials Science and Engineering, Monash University, Clayton, VIC, 3800 (Australia); Wang, Xiaochang C., E-mail: xcwang@xauat.edu.cn [School of Environmental and Municipal Engineering, Xi’an University of Architecture and Technology, Xi’an, Shaanxi Province, 710055 (China)

2017-04-05

Highlights: • A novel HOC process was firstly put forward to apply in wastewater reclamation. • Interactions between ozone and Al-based coagulants was found in the HOC process. • Ozonation can be catalyzed and enhanced by Al-based coagulants in the HOC process. • HOC process showed better organics removal than pre-ozonation-coagulation process. - Abstract: A novel hybrid ozonation-coagulation (HOC) process was developed for application in wastewater reclamation. In this process, ozonation and coagulation occurred simultaneously within a single unit. Compared with the conventional pre-ozonation-coagulation process, the HOC process exhibited much better performance in removing dissolved organic matters. In particular, the maximal organic matters removal efficiency was obtained at the ozone dosage of 1 mgO{sub 3}/mg DOC at each pH value (pH 5, 7 and 9). In order to interpret the mechanism of the HOC process, ozone decomposition was monitored. The results indicated that ozone decomposed much faster in the HOC process. Moreover, by using the reagent of O{sub 3}-resistant hydroxyl radical (·OH) probe compound, para-chlorobenzoic acid (pCBA), and electron paramagnetic resonance (EPR) analysis, it was observed that the HOC process generated higher content of ·OH compared with pre-ozonation process. This indicates that the ·OH oxidation reaction as the key step can be catalyzed and enhanced by Al-based coagulants and their hydrolyzed products in this developed process. Thus, based on the catalytic effects of Al-based coagulants on ozonation, the HOC process provides a promising alternative to the conventional technology for wastewater reclamation in terms of higher efficiency.

Use of electrocautery for coagulation and wound complications in Caesarean sections.

Science.gov (United States)

Moreira, Cristiane M; Amaral, Eliana

2014-01-01

To evaluate the safety of electrocautery for coagulation during Caesarean sections. A randomized, controlled, clinical pilot study was performed at a university maternity hospital. After admission for delivery and decision to perform a C-section, volunteers were randomized to either the intervention group (use of electrocautery for coagulation) or nonintervention group. The women were examined at the time of postpartum discharge (day 3), at days 7 to 10, and again at days 30 to 40 for signs of infection, hematoma, seroma, or dehiscence. Data were analyzed using an intention-to-treat analysis, and risk ratios were calculated. No significant differences were found between the two groups. Only 2.8% of patients in the intervention group developed surgical wound complications during hospitalization. However, 7 to 10 days following discharge, these rates reached 23.0% and 15.4% in the intervention and nonintervention groups, respectively (RR = 1.50, 95% CI = 0.84-2.60). Further studies should confirm whether the use of electrocautery for coagulation does not increase the risk of surgical wound complications in patients undergoing Caesarean sections.

Prognostic significance of blood coagulation tests in carcinoma of the lung and colon.

Science.gov (United States)

Wojtukiewicz, M Z; Zacharski, L R; Moritz, T E; Hur, K; Edwards, R L; Rickles, F R

1992-08-01

Blood coagulation test results were collected prospectively in patients with previously untreated, advanced lung or colon cancer who entered into a clinical trial. In patients with colon cancer, reduced survival was associated (in univariate analysis) with higher values obtained at entry to the study for fibrinogen, fibrin(ogen) split products, antiplasmin, and fibrinopeptide A and accelerated euglobulin lysis times. In patients with non-small cell lung cancer, reduced survival was associated (in univariate analysis) with higher fibrinogen and fibrin(ogen) split products, platelet counts and activated partial thromboplastin times. In patients with small cell carcinoma of the lung, only higher activated partial thromboplastin times were associated (in univariate analysis) with reduced survival in patients with disseminated disease. In multivariate analysis, higher activated partial thromboplastin times were a significant independent predictor of survival for patients with non-small cell lung cancer limited to one hemithorax and with disseminated small cell carcinoma of the lung. Fibrin(ogen) split product levels were an independent predictor of survival for patients with disseminated non-small cell lung cancer as were both the fibrinogen and fibrinopeptide A levels for patients with disseminated colon cancer. These results suggest that certain tests of blood coagulation may be indicative of prognosis in lung and colon cancer. The heterogeneity of these results suggests that the mechanism(s), intensity, and pathophysiological significance of coagulation activation in cancer may differ between tumour types.

THE RATIONALIZATION OF THE PARAMETERS OF MILK PROTEINS’ THERMO ACID COAGULATION BY BERRY COAGULANTS

Directory of Open Access Journals (Sweden)

Olena GREK

2017-03-01

Full Text Available This paper presents the results related to the influence of berry coagulant amount, its proactive acidity and duration of thermo acid coagulation on the process of milk proteins’ sedimentation. In the present work, the regression equations and response surface analysis were used to design and optimize an industrial bioprocess. Increase in the berry coagulant amount to 11 % and reduction of active acidity to 2.4 units were determined. pH up to 3 minutes is characterized by the highest processes of destabilization. Moreover, it improves the organoleptic properties and has the biggest impact on the yield of protein-berry clot (to 25 % and active acidity.

Magnetic particle imaging of blood coagulation

Energy Technology Data Exchange (ETDEWEB)

Murase, Kenya, E-mail: murase@sahs.med.osaka-u.ac.jp; Song, Ruixiao; Hiratsuka, Samu [Department of Medical Physics and Engineering, Division of Medical Technology and Science, Faculty of Health Science, Graduate School of Medicine, Osaka University, Osaka 565-0871 (Japan)

2014-06-23

We investigated the feasibility of visualizing blood coagulation using a system for magnetic particle imaging (MPI). A magnetic field-free line is generated using two opposing neodymium magnets and transverse images are reconstructed from the third-harmonic signals received by a gradiometer coil, using the maximum likelihood-expectation maximization algorithm. Our MPI system was used to image the blood coagulation induced by adding CaCl{sub 2} to whole sheep blood mixed with magnetic nanoparticles (MNPs). The “MPI value” was defined as the pixel value of the transverse image reconstructed from the third-harmonic signals. MPI values were significantly smaller for coagulated blood samples than those without coagulation. We confirmed the rationale of these results by calculating the third-harmonic signals for the measured viscosities of samples, with an assumption that the magnetization and particle size distribution of MNPs obey the Langevin equation and log-normal distribution, respectively. We concluded that MPI can be useful for visualizing blood coagulation.

Argon plasma coagulation for rectal bleeding after prostate brachytherapy

International Nuclear Information System (INIS)

Smith, Stephen; Wallner, Kent; Dominitz, Jason A.; Han, Ben; True, Lawrence; Sutlief, Steven; Billingsley, Kevin

2001-01-01

Purpose: To better define the efficacy and safety of argon plasma coagulation (APC), specifically for brachytherapy-related proctitis, we reviewed the clinical course of 7 patients treated for persistent rectal bleeding. Approximately 2-10% of prostate cancer patients treated with 125 I or 103 Pd brachytherapy will develop radiation proctitis. The optimum treatment for patients with persistent bleeding is unclear from the paucity of available data. Prior reports lack specific dosimetric information, and patients with widely divergent forms of radiation were grouped together in the analyses. Methods and Materials: Seven patients were treated with APC at the Veterans Affairs Puget Sound Health Care System and the University of Washington from 1997 to 1999 for persistent rectal bleeding due to prostate brachytherapy-related proctitis. Four patients received supplemental external beam radiation, delivered by a four-field technique. A single gastroenterologist at the Veterans Affairs Puget Sound Health Care System treated 6 of the 7 patients. If the degree of proctitis was limited, all sites of active bleeding were coagulated in symptomatic patients. An argon plasma coagulator electrosurgical system was used to administer treatments every 4-8 weeks as needed. The argon gas flow was set at 1.6 L/min, with an electrical power setting of 40-45 W. Results: The rectal V100 (the total rectal volume, including the lumen, receiving the prescription dose or greater) for the 7 patients ranged from 0.13 to 4.61 cc. Rectal bleeding was first noticed 3-18 months after implantation. APC (range 1-3 sessions) was performed 9-22 months after implantation. Five patients had complete resolution of their bleeding, usually within days of completing APC. Two patients had only partial relief from bleeding, but declined additional APC therapy. No patient developed clinically evident progressive rectal wall abnormalities after APC, (post-APC follow-up range 4-13 months). Conclusions: Most

A Novel Approach for Evaluating the Contraction of Hypo-Peritectic Steels during Initial Solidification by Surface Roughness

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Junli Guo

2018-04-01

Full Text Available The contraction of peritectic steels in the initial solidification has an important influence on the formation of surface defects of continuously cast slabs. In order to understand the contraction behavior of the initial solidification of steels in the mold, the solidification process and surface roughness in a commercial hypo-peritectic and several non-peritectic steels were investigated using Confocal Scanning Laser Microscope (CSLM. The massive transformation of delta-Fe (δ to austenite (γ was documented in the hypo-peritectic steel, which caused surface wrinkles and greatly increases the surface roughness of samples in the experiments. Surface roughness (Ra(δ→γ was calculated to evaluate the contraction level of the hypo-peritectic steel due to δ–γ transformation. The result shows that the surface roughness method can facilitate the estimation of the contraction level of peritectic transformation over a wide range of cooling rates.

Influence of the factor V Leiden mutation on infectious disease susceptibility and outcome

DEFF Research Database (Denmark)

Benfield, Thomas L; Dahl, Mortens; Nordestgaard, Borge G

2005-01-01

The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial.......The effect of the coagulation factor V Leiden mutation on infectious disease susceptibility and outcome is controversial....

OPPORTUNITY™: a large-scale randomized clinical trial of growth hormone in hemodialysis patients

DEFF Research Database (Denmark)

Kopple, Joel D; Cheung, Alfred K; Christiansen, Jens Sandahl

2011-01-01

Adult maintenance hemodialysis (MHD) patients experience high mortality and morbidity and poor quality of life (QoL). Markers of protein-energy wasting are associated with these poor outcomes. The OPPORTUNITY™ Trial examined whether recombinant human growth hormone (hGH) reduces mortality in hypo...... in hypoalbuminemic MHD patients. Secondary end points were effects on number of hospitalizations, cardiovascular events, lean body mass (LBM), serum proteins, exercise capacity, QoL and adverse events....

OPPORTUNITYTM: a large-scale randomized clinical trial of growth hormone in hemodialysis patients

DEFF Research Database (Denmark)

Kopple, Joel D; Cheung, Alfred K; Christiansen, Jens Sandahl

2011-01-01

Adult maintenance hemodialysis (MHD) patients experience high mortality and morbidity and poor quality of life (QoL). Markers of protein-energy wasting are associated with these poor outcomes. The OPPORTUNITY™ Trial examined whether recombinant human growth hormone (hGH) reduces mortality in hypo...... in hypoalbuminemic MHD patients. Secondary end points were effects on number of hospitalizations, cardiovascular events, lean body mass (LBM), serum proteins, exercise capacity, QoL and adverse events....

The Coagulation Profile of End-Stage Liver Disease and Considerations for Intraoperative Management.

Science.gov (United States)

Forkin, Katherine T; Colquhoun, Douglas A; Nemergut, Edward C; Huffmyer, Julie L

2018-01-01

The coagulopathy of end-stage liver disease results from a complex derangement in both anticoagulant and procoagulant processes. With even minor insults, cirrhotic patients experience either inappropriate bleeding or clotting, or even both simultaneously. The various phases of liver transplantation along with fluid and blood product administration may contribute to additional disturbances in coagulation. Thus, anesthetic management of patients undergoing liver transplantation to improve hemostasis and avoid inappropriate thrombosis in the perioperative environment can be challenging. To add to this challenge, traditional laboratory tests of coagulation are difficult to interpret in patients with end-stage liver disease. Viscoelastic coagulation tests such as thromboelastography (Haemonetics Corporation, Braintree, MA) and rotational thromboelastometry (TEM International, Munich, Germany) have helped to reduce transfusion of allogeneic blood products, especially fresh frozen plasma, but have also lead to the increased use of fibrinogen-containing products. In general, advancements in surgical techniques and anesthetic management have led to significant reduction in blood transfusion requirements during liver transplantation. Targeted transfusion protocols and pharmacologic prevention of fibrinolysis may further aid in the management of the complex coagulopathy of end-stage liver disease.

Exploration by radioactive fibrinogen of intrarenal coagulation phenomena. Preliminary results

International Nuclear Information System (INIS)

Simon, Jacques.

1974-01-01

The participation of fibrin deposits in kidney pathology was studied by the use of a radioactive tracer involved in the coagulation phenomenon: iodine 131-labelled fibrinogen. The isotopic exploration consists of a fibrinogen kinetics study combined with external counting over the kidney regions. The different stages of the procedure are described: separation, purification and labelling of fibrinogen; characteristics of the radioactive fibrinogen used; practical details of the examination itself; data analysis method. A chapter devoted to verifications and discussions of the procedure is followed by a report on the exploration of intrarenal coagulation phenomena in 30 kidney disease patients. In conclusion, the study of fibrinogen kinetics is considered as the most suitable method to detect local or slight intravascular coagulation phenomena. The sensitivity of the isotopic exploration is very satisfactory. The main criticism directed against this method is that the exploration is general and therefore blind [fr

Anomalous coagulation factors in non-arteritic anterior ischemic optic neuropathy with central retinal vein occlusion: A case report.

Science.gov (United States)

Kim, Ji Hong; Kang, Min Ho; Seong, Mincheol; Cho, Heeyoon; Shin, Yong Un

2018-04-01

Non-arteritic anterior ischemic optic neuropathy (NAION) is characterized by sudden, painless visual loss and optic disc edema. NAION occurs mainly in the presence of cardiovascular disease and hypercoagulability, mainly in patients over 50 years of age. We experienced a case of NAION associated with central retinal vein occlusion (CRVO) in a young man with no underlying disease. A 46-year-old man was referred to our clinic following a sudden loss of vision in his right eye. The patient exhibited no underlying disease and reported no ongoing medication. Significant visual loss and visual disturbance of the right eye were observed. The pupil of the right eye was enlarged and an afferent pupillary defect was observed. On fundus examination, retinal hemorrhage was observed in the peripheral retina; macular edema was observed in optical coherence tomography analysis. However, optic disc edema was not evident. No abnormal findings were found in routine blood tests for hypercoagulability. After 3 days of steroid intravenous injection, macular edema disappeared and visual acuity was improved, but optic disc edema began to appear. One week later, optic disc edema was evident and visual acuity was significantly reduced; thus, the patient was diagnosed with NAION. In fluorescein angiography, peripheral retinal ischemia was observed, suggesting that CRVO was complicated. Blood tests, including analysis of coagulation factors, were performed again, showing that coagulation factors IX and XI were increased. Anomalous coagulation factors in non-arteritic anterior ischemic optic neuropathy with central retinal vein occlusion. Systemic steroids were administered. One month later, optic disc edema and retinal hemorrhage gradually diminished and eventually disappeared; however, visual acuity did not recover. In young patients without underlying disease, cases of NAION require careful screening for coagulation disorders. Even if there is no abnormality in the test for routine

Bone Status Among Patients With Nonsurgical Hypoparathyroidism, Autosomal Dominant Hypocalcaemia, and Pseudohypoparathyroidism: A Cohort Study.

Science.gov (United States)

Underbjerg, Line; Malmstroem, Sofie; Sikjaer, Tanja; Rejnmark, Lars

2018-03-01

Nonsurgical hypoparathyroidism (Ns-HypoPT) and pseudohypoparathyroidism (PHP) are both rare diseases, characterized by hypocalcemia. In Ns-HypoPT, PTH levels are low, whereas patients with PHP often have very high levels due to receptor-insensitivity to PTH (PTH-resistance). Accordingly, we hypothesized that indices of bone turnover and bone mineralization/architecture are similar in Ns-HypoPT and PHP despite marked differences in PTH levels. We studied 62 patients with Ns-HypoPT and 31 with PHP as well as a group of age- and sex-matched healthy controls. We found a significantly higher areal BMD (aBMD) by DXA among patients with Ns-HypoPT, both compared with PHP and the background population. Compared with Ns-HypoPT, PHP patients had significantly lower total and trabecular volumetric BMD (vBMD) assessed by quantitative computed tomography (QCT) scans at the spine and hip. High-resolution peripheral quantitative computed tomography (HRpQCT) scans showed a lower trabecular area and vBMD as well as a lower trabecular number at the tibia in PHP compared to Ns-HypoPT and matched controls. In PHP, PTH levels correlated with levels of markers of bone formation (osteocalcin, bone-specific alkaline phosphatase, P1NP), and bone resorption (CTx). In adult males, levels of bone markers were significantly higher in PHP compared with Ns-HypoPT. Levels of procalcitonin and calcitonin were significantly higher in PHP compared with Ns-HypoPT. In conclusion, indices of bone turnover, density, and microarchitecture differ between patients with Ns-HypoPT and PHP. Our data suggest that patients with PHP do not have a complete skeletal resistance to PTH and that the effects of chronically high PTH levels in PHP are mostly confined to the trabecular tissue. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

The coagulation system in endocrine disorders: a narrative review

NARCIS (Netherlands)

Squizzato, A.; Gerdes, V. E. A.; Ageno, W.; Büller, H. R.

2007-01-01

Endocrine disorders can influence the haemostatic balance. Abnormal coagulation test results have been observed in patients with abnormal hormone levels. Also unprovoked bleeding or thrombotic events have been associated with endocrine disease. The aim of the present review is to summarise the

Coagulants modulate the hypocholesterolemic effect of tofu ...

African Journals Online (AJOL)

hope&shola

2006-02-02

Feb 2, 2006 ... The recent increase in soymilk and tofu (coagulated soymilk) consumption especially in western countries is due to the recognition of the health benefits of soy foods. The amount and the type of coagulated biomolecules (such as isoflavones) vary with the type of coagulant, and this will inevitable alter their ...

Coagulation parameters in copperhead compared to other Crotalinae envenomation: secondary analysis of the F(ab')2 versus Fab antivenom trial.

Science.gov (United States)

Gerardo, Charles J; Vissoci, Joao R Nickenig; Brown, Michael W J; Bush, Sean P

2017-02-01

Coagulation derangements in copperhead envenomation are considered less severe than other crotaline envenomations, resulting in recommendations to limit both coagulation testing and antivenom treatment. A prospective, blinded, multicenter, randomized clinical trial comparing the effectiveness of F(ab') 2 versus Fab antivenom in crotaline envenomation patients was completed in 2011. We determined the difference between coagulation parameters in copperhead compared to other crotaline envenomations. We performed a post hoc analysis comparing the coagulation parameters (platelets and fibrinogen) prospectively obtained in the aforementioned trial. All the patients received antivenom in one of three treatment arms [F(ab') 2 with maintenance, F(ab') 2 with placebo maintenance, or Fab with maintenance]. Coagulation parameters were measured at pretreatment baseline, during acute hospitalization, day 5, day 8, and day 15 post-envenomation. Mean platelet count and fibrinogen levels for the copperhead and other crotaline groups were compared. The platelet and fibrinogen point estimates with distribution are presented graphically over time. 122 patients were enrolled in the study. There were 22 patients with copperhead envenomation, 93 with other crotaline envenomations, and 7 that could not be definitively determined. The mean age was 42 (SD 20) years. There was a minor pretreatment difference in mean baseline platelet count between the copperhead group (246 × 109/L 95% CI 215, 277) compared to other crotaline envenomation patients (184 × 109/L 95% CI 167, 202). There was a modest pretreatment difference in mean fibrinogen level between copperhead patients (345 mg/dL 95% CI 277, 415) and other crotaline patients (261mg/dL 95% CI 241, 281). Pretreatment coagulation parameter means were normal and converged post treatment. On average, copperhead envenomations have less severe initial coagulation derangements. However, in mild envenomations, differences in laboratory

Reperfusion facilitates reversible disruption of the human blood-brain barrier following acute ischaemic stroke

International Nuclear Information System (INIS)

Liu, Chang; Zhang, Sheng; Yan, Shenqiang; Zhang, Ruiting; Shi, Feina; Lou, Min; Ding, Xinfa; Parsons, Mark

2018-01-01

We aimed to detect early changes of the blood-brain barrier permeability (BBBP) in acute ischaemic stroke (AIS), with or without reperfusion, and find out whether BBBP can predict clinical outcomes. Consecutive AIS patients imaged with computed tomographic perfusion (CTP) before and 24 h after treatment were included. The relative permeability-surface area product (rPS) was calculated within the hypoperfused region (rPS hypo-i ), non-hypoperfused region of ischaemic hemisphere (rPS nonhypo-i ) and their contralateral mirror regions (rPS hypo-c and rPS nonhypo-c ). The changes of rPS were analysed using analysis of variance (ANOVA) with repeated measures. Logistic regression was used to identify independent predictors of unfavourable outcome. Fifty-six patients were included in the analysis, median age was 76 (IQR 62-81) years and 28 (50%) were female. From baseline to 24 h after treatment, rPS hypo-i , rPS nonhypo-i and rPS hypo-c all decreased significantly. The decreases in rPS hypo-i and rPS hypo-c were larger in the reperfusion group than non-reperfusion group. The rPS hypo-i at follow-up was a predictor for unfavourable outcome (OR 1.131; 95% CI 1.018-1.256; P = 0.022). Early disruption of BBB in AIS is reversible, particularly when greater reperfusion is achieved. Elevated BBBP at 24 h after treatment, not the pretreatment BBBP, predicts unfavourable outcome. (orig.)

Reperfusion facilitates reversible disruption of the human blood-brain barrier following acute ischaemic stroke

Energy Technology Data Exchange (ETDEWEB)

Liu, Chang; Zhang, Sheng; Yan, Shenqiang; Zhang, Ruiting; Shi, Feina; Lou, Min [The Second Affiliated Hospital of Zhejiang University, School of Medicine, Department of Neurology, Hangzhou (China); Ding, Xinfa [The Second Affiliated Hospital of Zhejiang University, School of Medicine, Department of Radiology, Hangzhou (China); Parsons, Mark [John Hunter Hospital, University of Newcastle, Department of Neurology, Newcastle (Australia)

2018-02-15

We aimed to detect early changes of the blood-brain barrier permeability (BBBP) in acute ischaemic stroke (AIS), with or without reperfusion, and find out whether BBBP can predict clinical outcomes. Consecutive AIS patients imaged with computed tomographic perfusion (CTP) before and 24 h after treatment were included. The relative permeability-surface area product (rPS) was calculated within the hypoperfused region (rPS{sub hypo-i}), non-hypoperfused region of ischaemic hemisphere (rPS{sub nonhypo-i}) and their contralateral mirror regions (rPS{sub hypo-c} and rPS{sub nonhypo-c}). The changes of rPS were analysed using analysis of variance (ANOVA) with repeated measures. Logistic regression was used to identify independent predictors of unfavourable outcome. Fifty-six patients were included in the analysis, median age was 76 (IQR 62-81) years and 28 (50%) were female. From baseline to 24 h after treatment, rPS{sub hypo-i}, rPS{sub nonhypo-i} and rPS{sub hypo-c} all decreased significantly. The decreases in rPS{sub hypo-i} and rPS{sub hypo-c} were larger in the reperfusion group than non-reperfusion group. The rPS{sub hypo-i} at follow-up was a predictor for unfavourable outcome (OR 1.131; 95% CI 1.018-1.256; P = 0.022). Early disruption of BBB in AIS is reversible, particularly when greater reperfusion is achieved. Elevated BBBP at 24 h after treatment, not the pretreatment BBBP, predicts unfavourable outcome. (orig.)

Effect of Centrifuge Temperature on Routine Coagulation Tests.

Science.gov (United States)

Yazar, Hayrullah; Özdemir, Fatma; Köse, Elif

2018-01-01

This study investigated the effects of cooled and standard centrifuges on the results of coagulation tests to examine the effects of centrifugation temperature. Equal-volume blood samples from each patient were collected at the same time intervals and subjected to standard (25°C) and cooled centrifugation (2-4°C). Subsequently, the prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer values were determined in runs with the same lot numbers in the same coagulation device using the Dia-PT R (PT and INR), Dia-PTT-liquid (aPTT), Dia-FIB (fibrinogen), and Dia-D-dimer kits, respectively. The study enrolled 771 participants. The PT was significantly (p centrifuges were as follows: PT 10.30 versus 10.50 s; PT (INR) 1.04 versus 1.09 s; APTT 28.90 versus 29.40 s; fibrinogen 321.5 versus 322.1 mg/dL; and D-dimer 179.5 versus 168.7 µg FEU/mL. There were significant differences (p centrifuges. Centrifuge temperature can have a significant effect on the results of coagulation tests. However, broad and specific disease-based studies are needed. © 2018 S. Karger AG, Basel.

The role of coagulation and inflammation in the development of diabetic nephropathy in patients withdiabetes mellitus type 2

Directory of Open Access Journals (Sweden)

Yulia Valer'evna Khasanova

2012-03-01

Full Text Available Aim. To reveal the role of inflammatory markers (homocystein (HC, interleukin-6 (IL-6, components of hemostatic mechanism ofcoagulation in the development of diabetic nephropathy (DN in patients with type 2 diabetes mellitus (T2DM. Materials and methods. A total of 240 patients with T2DM and DN were examined. Results. Negative correlation between HC level and glomerular filtration rate (GFR (r= -0,38 and positive correlation between IL-6and fibrinogen (r=0,55 were observed. Conclusion. Inflammation and changes in mechanism of coagulation have influence on development and progression of DN in patientswith T2DM.

Ex Vivo Liver Experiment of Hydrochloric Acid-Infused and Saline-Infused Monopolar Radiofrequency Ablation: Better Outcomes in Temperature, Energy, and Coagulation

Energy Technology Data Exchange (ETDEWEB)

Jiang, Xiong-ying; Gu, Yang-kui; Huang, Jin-hua, E-mail: huangjh@sysucc.org.cn; Gao, Fei; Zou, Ru-hai; Zhang, Tian-qi [Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China (China)

2016-04-15

ObjectiveTo compare temperature, energy, and coagulation between hydrochloric acid-infused radiofrequency ablation (HAIRFA) and normal saline-infused radiofrequency ablation (NSIRFA) in ex vivo porcine liver model.Materials and Methods30 fresh porcine livers were excised in 60 lesions, 30 with HAIRFA and the other 30 with NSIRFA. Both modalities used monopolar perfusion electrode connected to a RF generator set at 103 °C and 30 W. In each group, ablation time was set at 10, 20, or 30 min (10 lesions from each group at each time). We compared tissue temperatures (at 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 cm away from the electrode tip), average power, deposited energy, deposited energy per coagulation volume (DEV), coagulation diameters, coagulative volume, and spherical ratio between the two groups.ResultsTemperature–time curves showed that HAIRFA provided progressively greater heating than that of NSIRFA. At 30 min, mean average power, deposited energy, coagulation volumes (113.67 vs. 12.28 cm{sup 3}) and diameters, and increasing in tissue temperature were much greater with HAIRFA (P < 0.001 for all), except DEV was lower (456 vs. 1396 J/cm{sup 3}, P < 0.001). The spherical ratio was closer to 1 with HAIRFA (1.23 vs. 1.46). Coagulation diameters, volume, and average power of HAIRFA increased significantly with longer ablation times. While with NSIRFA, these characteristics were stable till later 20 min, except the power decreased with longer ablation times.ConclusionsHAIRFA creates much larger and more spherical lesions by increasing overall energy deposition, modulating thermal conductivity, and transferring heat during ablation.

Coagulant recovery and reuse for drinking water treatment.

Science.gov (United States)

Keeley, James; Jarvis, Peter; Smith, Andrea D; Judd, Simon J

2016-01-01

Coagulant recovery and reuse from waterworks sludge has the potential to significantly reduce waste disposal and chemicals usage for water treatment. Drinking water regulations demand purification of recovered coagulant before they can be safely reused, due to the risk of disinfection by-product precursors being recovered from waterworks sludge alongside coagulant metals. While several full-scale separation technologies have proven effective for coagulant purification, none have matched virgin coagulant treatment performance. This study examines the individual and successive separation performance of several novel and existing ferric coagulant recovery purification technologies to attain virgin coagulant purity levels. The new suggested approach of alkali extraction of dissolved organic compounds (DOC) from waterworks sludge prior to acidic solubilisation of ferric coagulants provided the same 14:1 selectivity ratio (874 mg/L Fe vs. 61 mg/L DOC) to the more established size separation using ultrafiltration (1285 mg/L Fe vs. 91 mg/L DOC). Cation exchange Donnan membranes were also examined: while highly selective (2555 mg/L Fe vs. 29 mg/L DOC, 88:1 selectivity), the low pH of the recovered ferric solution impaired subsequent treatment performance. The application of powdered activated carbon (PAC) to ultrafiltration or alkali pre-treated sludge, dosed at 80 mg/mg DOC, reduced recovered ferric DOC contamination to water quality parameters. Several PAC-polished recovered coagulants provided the same or improved DOC and turbidity removal as virgin coagulant, as well as demonstrating the potential to reduce disinfection byproducts and regulated metals to levels comparable to that attained from virgin material. Copyright © 2015 Elsevier Ltd. All rights reserved.

Magnetic Resonance Mediated Radio Frequency Coagulation for Vascular Repair

Science.gov (United States)

Zhao, Ming

Purpose. Magnetic Resonance Mediated Radiofrequency Coagulation employs the RF heating effect of MRI scanning to coagulate biomaterials for repair of vascular defects. Coagulation of a protein biomaterial by MR-induced RF heating is a novel means to effect repair of defects such as aneurysms or arteriovenous malformations. Our novel method is to coagulate a thermosetting material (such as egg white, which can be used for investigating heat coagulation behavior and MR relaxation properties) delivered endovascularly by catheter and coagulated by RF-induced heating of an intracatheter resonant wire antenna in the scanner. Methods. Experiments were performed on a Siemens 1.5 T MRI scanner and a Bruker 14T NMR spectrometer. Egg white was brought to equilibrium at seven temperatures (20, 30, 40, 50, 60, 70 and 37 °C) in sequence. Measurement of the water spin-lattice relaxation time Ti, spin-spin relaxation time T2, spin-lattice relaxation time in the rotating frame T1p, or full width at half maximum of the MT spectrum were performed at each temperature. Relaxation parameters of raw egg white and egg white after coagulation at 70 °C were measured in the scanner at 20 °C to determine optimum inversion time, echo time and offset frequency for good image contrast between coagulated and uncoagulated protein. Finally, coagulation of egg white within a glass aneurysm phantom by RF heating in the scanner was performed to demonstrate the MR coagulation methodology and the ability to achieve image contrast between coagulated and uncoagulated biomaterial. Results. Water T2, T1p and MT gave the most definitive indication of the change from uncoagulated at low temperature to fully coagulated at 60 °C, while water T1 showed only the expected gradual increase with temperature, and no response to coagulation. MT weighted imaging is expected to be the optimum method to establish the coagulation condition of the biomaterial.

Coagulation and Mental Disorders

Directory of Open Access Journals (Sweden)

Silvia Hoirisch-Clapauch

2014-10-01

Full Text Available The neurovascular unit is a key player in brain development, homeostasis, and pathology. Mental stress affects coagulation, while severe mental illnesses, such as recurrent depression and schizophrenia, are associated with an increased thrombotic risk and cardiovascular morbidity. Evidence indicates that the hemostatic system is involved to some extent in the pathogenesis, morbidity, and prognosis of a wide variety of psychiatric disorders. The current review focuses on emerging data linking coagulation and some psychiatric disorders.

Removal of silver nanoparticles by coagulation processes

International Nuclear Information System (INIS)

Sun, Qian; Li, Yan; Tang, Ting; Yuan, Zhihua; Yu, Chang-Ping

2013-01-01

Highlights: • This study investigated the removal of AgNP suspensions by four regular coagulants. • The optimal removal efficiencies for the four coagulants were achieved at pH 7.5. • The removal efficiency of AgNPs was affected by the natural water characteristics. • TEM and XRD showed that AgNPs or silver-containing NPs were adsorbed onto the flocs. -- Abstract: Commercial use of silver nanoparticles (AgNPs) will lead to a potential route for human exposure via potable water. Coagulation followed by sedimentation, as a conventional technique in the drinking water treatment facilities, may become an important barrier to prevent human from AgNP exposures. This study investigated the removal of AgNP suspensions by four regular coagulants. In the aluminum sulfate and ferric chloride coagulation systems, the water parameters slightly affected the AgNP removal. However, in the poly aluminum chloride and polyferric sulfate coagulation systems, the optimal removal efficiencies were achieved at pH 7.5, while higher or lower of pH could reduce the AgNP removal. Besides, the increasing natural organic matter (NOM) would reduce the AgNP removal, while Ca 2+ and suspended solids concentrations would also affect the AgNP removal. In addition, results from the transmission electron microscopy and X-ray diffraction showed AgNPs or silver-containing nanoparticles were adsorbed onto the flocs. Finally, natural water samples were used to validate AgNP removal by coagulation. This study suggests that in the case of release of AgNPs into the source water, the traditional water treatment process, coagulation/sedimentation, can remove AgNPs and minimize the silver ion concentration under the well-optimized conditions

Predictive Value of Whole Blood and Plasma Coagulation Tests for Intra- and Postoperative Bleeding Risk: A Systematic Review

DEFF Research Database (Denmark)

Larsen, Julie Brogaard; Hvas, Anne-Mette

2017-01-01

review of the existing literature assessing the ability of whole blood coagulation (thromboelastography [TEG]/thromboelastometry [ROTEM]/Sonoclot), platelet function tests, and standard plasma-based coagulation tests to predict bleeding in the perioperative setting. We searched PubMed and Embase...... value of testing in patients receiving antithrombotic medication. In general, studies reported low positive predictive values for perioperative testing, whereas negative predictive values were high. The studies yielded moderate areas under receiver operator characteristics (ROC) curve (for the majority...... recommend that both whole blood and plasma-based coagulation tests are primarily used in case of bleeding and not for screening in unselected patients prior to surgery....

An assessment of the utility of unselected coagulation screening in general hospital practice.

LENUS (Irish Health Repository)

McHugh, Johnny

2011-03-01

Coagulation screening using prothrombin time (PT) and activated partial thromboplastin time (APTT) is widely used. We performed an audit of coagulation screening in an Irish teaching hospital. We analysed PT and\\/or APTT results received during normal working hours during a 1-week period in our hospital. Abnormal results due to anticoagulants were excluded from further study. In samples with PT longer than 15.5 s and\\/or APTT longer than 42 s, we proceeded to 1: 1 mixing studies if the PT was prolonged and 1: 1 mixing studies, factor XII assay and lupus screen if the APTT was prolonged. We also obtained referral source for all samples and clinical details for abnormal samples. Six hundred and seventy-one coagulation requests were received during the study period. Three hundred and eighteen of 671 (47.4%) coagulation requests were for monitoring of anticoagulation. Three hundred and fifty-three of 671 (52.6%) requests were for coagulation screening rather than anticoagulant monitoring. In the coagulation screens received, PT was prolonged in 19 of 353 (5.4%). PT was longer than 20 s in four of 353 cases (1.1%). APTT was prolonged in 19 of 353 (5.4%). APTT was longer than 50 s in four of 353 (1.1%). No patients with abnormal PT or APTT had any bleeding sequelae during the study period. Unregulated coagulation screening has a low yield of abnormal results; the majority of these abnormal results show mild prolongation of PT or APTT with no evidence that they are associated with an increased bleeding risk.

Optical coherence tomography-guided laser microsurgery for blood coagulation with continuous-wave laser diode.

Science.gov (United States)

Chang, Feng-Yu; Tsai, Meng-Tsan; Wang, Zu-Yi; Chi, Chun-Kai; Lee, Cheng-Kuang; Yang, Chih-Hsun; Chan, Ming-Che; Lee, Ya-Ju

2015-11-16

Blood coagulation is the clotting and subsequent dissolution of the clot following repair to the damaged tissue. However, inducing blood coagulation is difficult for some patients with homeostasis dysfunction or during surgery. In this study, we proposed a method to develop an integrated system that combines optical coherence tomography (OCT) and laser microsurgery for blood coagulation. Also, an algorithm for positioning of the treatment location from OCT images was developed. With OCT scanning, 2D/3D OCT images and angiography of tissue can be obtained simultaneously, enabling to noninvasively reconstruct the morphological and microvascular structures for real-time monitoring of changes in biological tissues during laser microsurgery. Instead of high-cost pulsed lasers, continuous-wave laser diodes (CW-LDs) with the central wavelengths of 450 nm and 532 nm are used for blood coagulation, corresponding to higher absorption coefficients of oxyhemoglobin and deoxyhemoglobin. Experimental results showed that the location of laser exposure can be accurately controlled with the proposed approach of imaging-based feedback positioning. Moreover, blood coagulation can be efficiently induced by CW-LDs and the coagulation process can be monitored in real-time with OCT. This technology enables to potentially provide accurate positioning for laser microsurgery and control the laser exposure to avoid extra damage by real-time OCT imaging.

Bloodcurdling movies and measures of coagulation: Fear Factor crossover trial.

Science.gov (United States)

Nemeth, Banne; Scheres, Luuk J J; Lijfering, Willem M; Rosendaal, Frits R

2015-12-16

To assess whether, as has been hypothesised since medieval times, acute fear can curdle blood. Crossover trial. Main meeting room of Leiden University's Department of Clinical Epidemiology, the Netherlands, converted to a makeshift cinema. 24 healthy volunteers aged ≤30 years recruited among students, alumni, and employees of the Leiden University Medical Center: 14 were assigned to watch a frightening (horror) movie followed by a non-threatening (educational) movie and 10 to watch the movies in reverse order. The movies were viewed more than a week apart at the same time of day and both lasted approximately 90 minutes. The primary outcome measures were markers, or "fear factors" of coagulation activity: blood coagulant factor VIII, D-dimer, thrombin-antithrombin complexes, and prothrombin fragments 1+2. The secondary outcome was participant reported fear experienced during each movie using a visual analogue fear scale. All participants completed the study. The horror movie was perceived to be more frightening than the educational movie on a visual analogue fear scale (mean difference 5.4, 95% confidence interval 4.7 to 6.1). The difference in factor VIII levels before and after watching the movies was higher for the horror movie than for the educational movie (mean difference of differences 11.1 IU/dL (111 IU/L), 95% confidence interval 1.2 to 21.0 IU/dL). The effect of either movie on levels of thrombin-antithrombin complexes, D-dimer, and prothrombin fragments 1+2 did not differ. Frightening (in this case, horror) movies are associated with an increase of blood coagulant factor VIII without actual thrombin formation in young and healthy adults. Trial registration ClinicalTrials.gov NCT02601053. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Imaging of blood plasma coagulation at supported lipid membranes.

Science.gov (United States)

Faxälv, Lars; Hume, Jasmin; Kasemo, Bengt; Svedhem, Sofia

2011-12-15

The blood coagulation system relies on lipid membrane constituents to act as regulators of the coagulation process upon vascular trauma, and in particular the 2D configuration of the lipid membranes is known to efficiently catalyze enzymatic activity of blood coagulation factors. This work demonstrates a new application of a recently developed methodology to study blood coagulation at lipid membrane interfaces with the use of imaging technology. Lipid membranes with varied net charges were formed on silica supports by systematically using different combinations of lipids where neutral phosphocholine (PC) lipids were mixed with phospholipids having either positively charged ethylphosphocholine (EPC), or negatively charged phosphatidylserine (PS) headgroups. Coagulation imaging demonstrated that negatively charged SiO(2) and membrane surfaces exposing PS (obtained from liposomes containing 30% of PS) had coagulation times which were significantly shorter than those for plain PC membranes and EPC exposing membrane surfaces (obtained from liposomes containing 30% of EPC). Coagulation times decreased non-linearly with increasing negative surface charge for lipid membranes. A threshold value for shorter coagulation times was observed below a PS content of ∼6%. We conclude that the lipid membranes on solid support studied with the imaging setup as presented in this study offers a flexible and non-expensive solution for coagulation studies at biological membranes. It will be interesting to extend the present study towards examining coagulation on more complex lipid-based model systems. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of nano-scale curvature on the intrinsic blood coagulation system

Science.gov (United States)

Kushida, Takashi; Saha, Krishnendu; Subramani, Chandramouleeswaran; Nandwana, Vikas; Rotello, Vincent M.

2014-11-01

The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation `silent' surface, while nanoparticles with lower surface curvature show denaturation and concomitant coagulation.The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation `silent' surface, while nanoparticles with lower surface curvature show denaturation and concomitant coagulation. Electronic supplementary information (ESI) available: Physical properties and scanning electron micrographs (SEM) of silica NPs, intrinsic coagulation activity after 3 h. See DOI: 10.1039/c4nr04128c

Lowering blood glucose during hip surgery does not influence coagulation activation

Directory of Open Access Journals (Sweden)

Marjolein K. Sechterberger

2015-06-01

Conclusion: Although the human GLP-1 analogue liraglutide moderately reduced post-operative blood glucose levels in non-diabetic and prediabetic obese patients undergoing elective hip surgery, no changes were observed with respect to coagulation activation.

Evaluation of Disseminated Intravascular Coagulation in the Craniocerebral Traumas

Directory of Open Access Journals (Sweden)

Faruk Altinel

2014-06-01

Full Text Available Traumatic injury is one of the most important cause of disseminated intravascular coagulation (DIC. It occurs because of blood loss and hemodilution due to fluid resuscitation. The incidence of trauma associated DIC is mainly higher in the craniocerebral traumas. Even though craniocerebral trauma related DIC is well defined, the pathophysiology has been poorly characterized in the literature. Due to the fact that brain tissue is highly significant for procoagulant molecules, craniocerebral traumas are closely related to DIC. In the current study, 30 patients admitted to emergency room have been considered on the first and fifth day of admission to the hospital for the coagulation tests to evaluate DIC in both two groups. [Cukurova Med J 2014; 39(3.000: 488-495

Protein metabolism in hypo- and hyperstimulated rat thyroid glands. Pt. 2

International Nuclear Information System (INIS)

Pavlovic-Hournac, M.; Delbauffe, D.

1976-01-01

The rate of degradation of total thyroidal proteins is modified in differently stimulated glands. It is slowed down in hypostimulated thyroids and accelerated in hyperstimulated ones. Comparative evaluation of the rates degradation (either in absolute terms - DPM/mg of tissue or as specific activity) of different proteins shows that a modified hormonal state affects the degradation of thyroglobulin much more significantly than the degradation of non-thyroglobulin proteins. In the absence of thyrotropic hormone (TSH) the degradation of throglobulin is almost completely inhibited, while with excess of hormone it is dramatically accelerated. Comparing the TSH action on the synthesis with its effect on the degradation of thyroglobulin, it appears that it has a much stronger effect on the process of degradation than on the process of synthesis. This means that TSH significantly modifies the turnover of thyroglobulin. This effect of TSH leads, in chronically hypo- or hyperstimulated glands to the new levels of colloidal thyroglobulin which are highly increased in hypostimulated and significantly decreased in hyperstimulated glands. These results are in perfect agreement with the classical morphological description of hypo- and hyperstimulated glands. (orig.) [de

Self-production of tissue factor-coagulation factor VII complex by ovarian cancer cells.

Science.gov (United States)

Yokota, N; Koizume, S; Miyagi, E; Hirahara, F; Nakamura, Y; Kikuchi, K; Ruf, W; Sakuma, Y; Tsuchiya, E; Miyagi, Y

2009-12-15

Thromboembolic events are a major complication in ovarian cancer patients. Tissue factor (TF) is frequently overexpressed in ovarian cancer tissue and correlates with intravascular thrombosis. TF binds to coagulation factor VII (fVII), changing it to its active form, fVIIa. This leads to activation of the extrinsic coagulation cascade. fVII is produced by the liver and believed to be supplied from blood plasma at the site of coagulation. However, we recently showed that ovarian cancer cells express fVII transcripts under normoxia and that this transcription is inducible under hypoxia. These findings led us to hypothesise that ovarian cancer cells are intrinsically associated with TF-fVIIa coagulation activity, which could result in thrombosis. In this study, we examined whether ectopically expressed fVII could cause thrombosis by means of immunohistochemistry, RT-PCR, western blotting and flow cytometry. Ectopic fVII expression occurs frequently in ovarian cancers, particularly in clear cell carcinoma. We further showed that ovarian cancer cells express TF-fVIIa on the cell surface under normoxia and that this procoagulant activity is enhanced by hypoxic stimuli. Moreover, we showed that ovarian cancer cells secrete microparticles (MPs) with TF-fVIIa activity. Production of this procoagulant secretion is enhanced under hypoxia. These results raise the possibility that cancer cell-derived TF-fVIIa could cause thrombotic events in ovarian cancer patients.

Comparison of Moringa stenopetala seed extract as a clean coagulant with Alum and Moringa stenopetala-Alum hybrid coagulant to remove direct dye from Textile Wastewater.

Science.gov (United States)

Dalvand, Arash; Gholibegloo, Elham; Ganjali, Mohammad Reza; Golchinpoor, Najmeh; Khazaei, Mohammad; Kamani, Hossein; Hosseini, Sara Sadat; Mahvi, Amir Hossein

2016-08-01

In this study, the efficiency of Moringa stenopetala seed extract was compared with alum and M. stenopetala-alum hybrid coagulant to remove Direct Red 23 azo dye from textile wastewater. The effects of parameters such as pH, coagulant dose, type of salt used for the extraction of coagulant and initial dye concentration on dye removal efficiency were investigated. Moreover, the existing functional groups on the structure of M. stenopetala coagulant (MSC) were determined by Fourier transform infrared spectroscopy, and the morphology of sludge produced by MSC, alum, and hybrid coagulant was characterized by scanning electron microscopy. Ninhydrin test was also used to determine the quantity of primary amines in the MSC and Moringa oleifera coagulant (MOC). According to the results, with increasing the coagulant dose and decreasing the initial dye concentration, dye removal efficiency has increased. The maximum dye removal of 98.5, 98.2, and 98.3 % were obtained by using 240, 120, and 80 mg/L MSC, alum and hybrid coagulant at pH 7, respectively. The results also showed MSC was much more effective than MOC for dye removal. The volume of sludge produced by MSC was one fourth and half of those produced by alum and hybrid coagulant, respectively. Based on the results, hybrid coagulant was the most efficient coagulant for direct dye removal from colored wastewater.

Treatment of tracheal mucoepidermoid carcinoma by argon plasma coagulation during pregnancy.

Science.gov (United States)

Kesrouani, Assaad; Dabar, Georges; Rahal, Samir; Ghorra, Claude

2015-05-01

Mucoepidermoid carcinoma of the tracheobronchial tree is a rare airway tumor (cesarean section. We report the first case to be treated by Argon-Plasma Coagulation (APC) in pregnancy. A 35-year-old Caucasian woman G1P0, at 27 weeks of gestation was admitted to the emergency department because of hemoptysis and severe dyspnea. Bronchoscopy and biopsies diagnosed primary tracheal mucoepidermoid carcinoma. Following an episode of tracheal bleeding, she was intubated. After thorough explanations to the family and obtaining informed consent, therapeutic bronchoscopy, under general anesthesia using a rigid bronchoscope, was performed. The tumor was cored out with the tip of the bronchoscope and removed with an alligator forceps. The tumor bed was coagulated with APC. The obstetrical team was ready to intervene in case of maternal emergency. Immediate follow-up was good, and she left the hospital 4 days later. She delivered at 39 weeks of gestation by cesarean section because of dystocia. Five years later, the patient is doing well without any signs or symptoms of recurrence. Pediatric follow-up is normal. Argon Plasma Coagulation for treatment of mucoepidermoid tracheal carcinoma is feasible during pregnancy. Reporting this case could lead to less aggressive management of mucoepidermoid carcinoma in pregnant patients.

Coagulation and fibrinolysis in hyperparathyroidism secondary to vitamin D deficiency

NARCIS (Netherlands)

Elbers, Laura P. B.; Wijnberge, Marije; Meijers, Joost C. M.; Poland, Dennis C. W.; Brandjes, Dees P. M.; Fliers, Eric; Gerdes, Victor E. A.

2018-01-01

Abnormal coagulation tests have been observed in patients with primary hyperparathyroidism (HPT) suggesting a prothrombotic effect of parathyroid hormone (PTH). Vitamin D deficiency (VIDD) is the most frequent cause of secondary HPT. Aim of our study was to investigate the influence of HPT secondary

Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours

Energy Technology Data Exchange (ETDEWEB)

Rempp, Hansjoerg; Hoffmann, Ruediger; Buck, Alexandra; Claussen, Claus D.; Schick, Fritz; Clasen, Stephan [Eberhard Karls University of Tuebingen, Department on Diagnostic and Interventional Radiology, Tuebingen (Germany); Roland, Joerg; Kickhefel, Antje [Siemens Healthcare, Erlangen (Germany); Pereira, Philippe L. [Clinic for radiology, Nuclear Medicine and Minimal Invasive Therapies, SLK-Clinics, Heilbronn (Germany)

2012-05-15

To evaluate different cut-off temperature levels for a threshold-based prediction of the coagulation zone in magnetic resonance (MR)-guided radiofrequency (RF) ablation of liver tumours. Temperature-sensitive measurements were acquired during RF ablation of 24 patients with primary (6) and secondary liver lesions (18) using a wide-bore 1.5 T MR sytem and compared with the post-interventional coagulation zone. Temperature measurements using the proton resonance frequency shift method were performed directly subsequent to energy application. The temperature maps were registered on the contrast-enhanced follow-up MR images acquired 4 weeks after treatment. Areas with temperatures above 50 , 55 and 60 C were segmented and compared with the coagulation zones. Sensitivity and positive predictive value were calculated. No major complications occurred and all tumours were completely treated. No tumour recurrence was observed at the follow-up examination after 4 weeks. Two patients with secondary liver lesions showed local tumour recurrence after 4 and 7 months. The 60 C threshold level achieved the highest positive predictive value (87.7 {+-} 9.9) and the best prediction of the coagulation zone. For a threshold-based prediction of the coagulation zone, the 60 C cut-off level achieved the best prediction of the coagulation zone among the tested levels. (orig.)

Threshold-based prediction of the coagulation zone in sequential temperature mapping in MR-guided radiofrequency ablation of liver tumours

International Nuclear Information System (INIS)

Rempp, Hansjoerg; Hoffmann, Ruediger; Buck, Alexandra; Claussen, Claus D.; Schick, Fritz; Clasen, Stephan; Roland, Joerg; Kickhefel, Antje; Pereira, Philippe L.

2012-01-01

To evaluate different cut-off temperature levels for a threshold-based prediction of the coagulation zone in magnetic resonance (MR)-guided radiofrequency (RF) ablation of liver tumours. Temperature-sensitive measurements were acquired during RF ablation of 24 patients with primary (6) and secondary liver lesions (18) using a wide-bore 1.5 T MR sytem and compared with the post-interventional coagulation zone. Temperature measurements using the proton resonance frequency shift method were performed directly subsequent to energy application. The temperature maps were registered on the contrast-enhanced follow-up MR images acquired 4 weeks after treatment. Areas with temperatures above 50 , 55 and 60 C were segmented and compared with the coagulation zones. Sensitivity and positive predictive value were calculated. No major complications occurred and all tumours were completely treated. No tumour recurrence was observed at the follow-up examination after 4 weeks. Two patients with secondary liver lesions showed local tumour recurrence after 4 and 7 months. The 60 C threshold level achieved the highest positive predictive value (87.7 ± 9.9) and the best prediction of the coagulation zone. For a threshold-based prediction of the coagulation zone, the 60 C cut-off level achieved the best prediction of the coagulation zone among the tested levels. (orig.)

Polyferric sulphate: preparation, characterisation and application in coagulation experiments.

Science.gov (United States)

Zouboulis, A I; Moussas, P A; Vasilakou, F

2008-07-15

The process of coagulation is a core environmental protection technology, which is mainly used in the water or wastewater treatment facilities. Research is now focused on the development of inorganic pre-polymerised coagulants. A characteristic example is PFS (polyferric sulphate), a relatively new pre-polymerised inorganic coagulant with high cationic charge. In this paper, the role of major parameters, including temperature, types of chemical reagents, ratio r=[OH]/[Fe], rate of base addition in the preparation stages of PFS were investigated. Furthermore, the prepared PFS was characterised based on typical properties, such as the percentage of the polymerised iron present in the compound, z-potential, pH, etc. Moreover, dynamics of coagulation process were examined by means of the Photometric Dispersion Analyzer (PDA). Finally, the coagulation efficiency of PFS in treating kaolin suspension and biologically pre-treated wastewater was evaluated in comparison with the respective conventional coagulant agent. The results indicate that certain parameters, such as the r value, the rate of base addition and the duration and temperature of the polymerisation stage, significantly affected the properties of the PFS. Additionally, the prepared PFS polymerised coagulants exhibit a significantly better coagulation performance than the respective non-polymerised one, i.e. ferric sulphate.

Correction of subclinical coagulation disorders before percutaneous dilatational tracheotomy. A randomised controlled trial

NARCIS (Netherlands)

Veelo, Denise P.; Vlaar, Alexander P.; Dongelmans, Dave A.; Binnekade, Jan M.; Levi, Marcel; Paulus, Frederique; Berends, Fenny; Schultz, Marcus J.

2012-01-01

Background. There is evidence that percutaneous dilatational tracheotomy (PDT) can be safely performed in patients with severe coagulation disorders if these are carefully corrected immediately before the procedure. However, it is currently unclear whether PDT can be performed safely in patients in

Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

International Nuclear Information System (INIS)

Leborgne, Felix; Fowler, Jack

2009-01-01

Purpose: To study retrospectively late complications and biochemical control in patients treated with three-dimensional conformal external-beam radiotherapy for localized prostate cancer administered using hypofractionation vs. a standard fractionation regimen. The hypofractionation regimen (Hypo) was designed to avoid more late rectal reactions and to be done in half as many treatment sessions. Methods and Materials: Eighty-nine nonrandomized patients chose Hypo delivered in 20 fractions of 3 Gy (n = 52) or 3.15 Gy (n = 37) for a median overall treatment time of 33 days. One hundred thirty comparable patients were contemporaneously treated with standard fractionation to a median dose of 78 Gy delivered over 55 days. The median follow-up time was 49 months (range, 24-73 months). Results: The 5-year actuarial biochemical control rates were 96%, 84%, and 85% for low-, medium-, and high-risk disease in the Hypo group, respectively. The respective rates in the standard fractionation group were 98%, 84%, and 87%, with no statistical difference between the two groups. The rate of rectal Grade 2-4 complications was 5.5% in both treatment groups and of urinary Grade 2-4 complications was 5.6% in the Hypo and 3% in the standard group (p = 0.36). Similarly, there were no statistical differences in the rate of late complications between patients treated with 3 Gy/fraction vs. 3.15 Gy/fraction. Conclusions: Our preliminary results showed that the Hypo regimen is feasible and does not reduce biochemical control compared with standard fractionation. The incidence of late complications was not increased when the tumor normalized total doses at 2Gy/fraction was increased from 77.1 to 83.7 Gy in patients treated with either 3 or 3.15 Gy/fraction in the Hypo group, respectively.

Fetomaternal Outcome with Hepatitis E in Pregnancy

International Nuclear Information System (INIS)

Yasmeen, T.; Hashmi, H.A.; Taj, A.

2013-01-01

Objective: To assess the maternal morbidity and mortality and fetal outcome with hepatitis E (HEV) in pregnancy. Study Design: Cross-sectional study. Place and Duration of Study: Liaquat National Hospital, Karachi, from May 2008 to April 2010. Methodology: Thirty patients admitted at Gynae Ward with serologically proven HEV in pregnancy were included in the study. All these patients were followed during their hospital stay with liver function tests and coagulation profile. Maternal morbidity and mortality and fetal outcome were recorded. Results: Maximum maternal morbidities were noted in patients who presented in 3rd trimester, both clinically and derangement of haematological and biochemical tests. Out of 30 patients, 08 patients expired with maternal mortality rate of 29.3% and rest were discharged safely. Perinatal mortality rate was 30.3 per 1000 live births. Conclusion: Hepatitis E runs a fulminant course during pregnancy with very high mortality rate especially during third trimester and postpartum period. (author)

Predictive factors for beneficial application of high-frequency electromagnetics for tumour vaporization and coagulation in neurosurgery

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Koerbel Andrei

2008-04-01

Full Text Available Abstract Objective To identify preoperative and intraoperative factors and conditions that predicts the beneficial application of a high-frequency electromagnetic field (EMF system for tumor vaporization and coagulation. Methods One hundred three subsequent patients with brain tumors were microsurgically treated using the EMF system in addition to the standard neurosurgical instrumentarium. A multivariate analysis was performed regarding the usefulness (ineffective/useful/very helpful/essential of the new technology for tumor vaporization and coagulation, with respect to tumor histology and location, tissue consistency and texture, patients' age and sex. Results The EMF system could be used effectively during tumor surgery in 83 cases with an essential contribution to the overall success in 14 cases. In the advanced category of effectiveness (very helpful/essential, there was a significant difference between hard and soft tissue consistency (50 of 66 cases vs. 3 of 37 cases. The coagulation function worked well (very helpful/essential for surface (73 of 103 cases and spot (46 of 103 cases coagulation when vessels with a diameter of less than one millimeter were involved. The light-weight bayonet hand piece and long malleable electrodes made the system especially suited for the resection of deep-seated lesions (34 of 52 cases compared to superficial tumors (19 of 50 cases. The EMF system was less effective than traditional electrosurgical devices in reducing soft glial tumors. Standard methods where also required for coagulation of larger vessels. Conclusion It is possible to identify factors and conditions that predict a beneficial application of high-frequency electromagnetics for tumor vaporization and coagulation. This allows focusing the use of this technology on selective indications.

Clinical outcomes of Laparoscopically Assisted Vaginal Hysterectomy at patients who had previous abdominopelvic surgery

Directory of Open Access Journals (Sweden)

Ali Riza Odabasi

2007-03-01

Full Text Available OBJECTIVE: To determine clinical outcomes of Laparoscopically Assisted Vaginal Hysterectomy (LAVH at patients who had previous abdominopelvic surgery.\tDesign: A clinical observational, prospective, non randomised trial comparing outcomes of 13 patients who had previous abdominopelvic surgery with outcomes of 19 patients who had not surgery.\tSetting: Adnan Menderes University Faculty of Medicine, Department of Obstetrics and Gynecology.\tPatients: Thirty-two subjects [average age 51,1±6,9 (37-66] who had indication of total abdominal hysterectomy and bilateral\tsalpingooferectomy due to benign pathologies.\tInterventions: According to ACOG, LAVH was performed by using the Garry technique at the trocar insertions, the Reich technique\tat the laparoscopic phase and the Heaney technique at the vaginal phase by the same operator. After adhesiolysis and diagnostic procedures, ureters were dissected medially. By coagulating, bilateral round and infundibulopelvic ligaments were cut after the\tmobilisation of bladder. The operation was completed by the same operation team by vaginal approach consequently. At all operations, 80 W unipolar or 150 W bipolar diathermic dissection and 25-35 W unipolar diathermic cutting were performed.\tMain outcome measures: Age, parity, menopausal status, preoperative indications, type of previous abdominopelvic surgey and incision, intraoperative indications, adhesion scores, rate of unintended laparotomy, operative time, uterus weight, loss of blood,\tcomplications, postoperative pain scores and analgesic requirements, time necessary for returning to normal intestinal function, length of hospitalisation and rate of readmission to hospital.\tRESULTS: When compared with the patients who had not previous abdominopelvic surgery, all adhesion scores, uterus weight, operative time and the number of total postoperative complications were found significantly high at patients who had previous\tsurgery. Loss of blood, the rate

Computing the Risk of Postprandial Hypo- and Hyperglycemia in Type 1 Diabetes Mellitus Considering Intrapatient Variability and Other Sources of Uncertainty

Science.gov (United States)

García-Jaramillo, Maira; Calm, Remei; Bondia, Jorge; Tarín, Cristina; Vehí, Josep

2009-01-01

Objective The objective of this article was to develop a methodology to quantify the risk of suffering different grades of hypo- and hyperglycemia episodes in the postprandial state. Methods Interval predictions of patient postprandial glucose were performed during a 5-hour period after a meal for a set of 3315 scenarios. Uncertainty in the patient's insulin sensitivities and carbohydrate (CHO) contents of the planned meal was considered. A normalized area under the curve of the worst-case predicted glucose excursion for severe and mild hypo- and hyperglycemia glucose ranges was obtained and weighted accordingly to their importance. As a result, a comprehensive risk measure was obtained. A reference model of preprandial glucose values representing the behavior in different ranges was chosen by a ξ2 test. The relationship between the computed risk index and the probability of occurrence of events was analyzed for these reference models through 19,500 Monte Carlo simulations. Results The obtained reference models for each preprandial glucose range were 100, 160, and 220 mg/dl. A relationship between the risk index ranges 120 and the probability of occurrence of mild and severe postprandial hyper- and hypoglycemia can be derived. Conclusions When intrapatient variability and uncertainty in the CHO content of the meal are considered, a safer prediction of possible hyper- and hypoglycemia episodes induced by the tested insulin therapy can be calculated. PMID:20144339

Effect of Dan seven soft capsule adjuvant therapy on serum inflammatory factors, coagulation function and blood rheology indexes in patients with acute hemorrhagic cerebrovascular disease

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Shu-Hua Gui

2017-08-01

Full Text Available Objective: To investigate the effect of Dan seven soft capsule on the treatment of acute hemorrhagic cerebrovascular disease and the influence of serum inflammatory factors, coagulation function and blood rheology indexes. Methods: A total of 112 cases of patients with acute hemorrhagic cerebrovascular disease, according to the random data table were divided into the control group (n=57 and observation group (n=55, the patients in the control group received routine treatment combined with edaravone, on the basis of the treatment of the control group, the observation group was treated with Dan seven soft capsule. The serum levels of inflammatory factors, coagulation function and blood rheology indexes were compared between the two groups before and after treatment. Results: Before treatment, there were no significant difference in the inflammatory factors (hs-CRP, TNF-α and IL-6, blood coagulation function (FIB, PT and APTT and hemorheology (high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity levels between the control group and observation group. Compared with the levels of the same group before treatment, two groups of hs-CRP, TNF-α, IL-6, FIB, high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity level after treatment were significantly decreased, and levels in the observation group were significantly lower than those in the control group; Compared with the group before treatment, the levels of PT and APTT in the two groups were significantly increased, and the observation group was significantly higher than the control group. Conclusion: Dan seven soft capsule in the treatment of acute hemorrhagic cerebrovascular disease can effectively reduce the level of serum inflammatory factors, improve coagulation function and blood rheology index, it has an important clinical value.

Coagulation and Adsorption Treatment of Printing Ink Wastewater

OpenAIRE

Klančnik, Maja

2014-01-01

The intention of the study was to improve the efficiency of total organic carbon (TOC) and colour removal from the wastewater samples polluted with flexographic printing ink following coagulation treatments with further adsorption onto activated carbons and ground orange peel. The treatment efficiencies were compared to those of further flocculation treatments and of coagulation and adsorption processes individually. Coagulation was a relatively effective single-treatment method, removing 99...

Effects of anti-aggregant, anti-inflammatory and anti-coagulant drug consumption on the preparation and therapeutic potential of plasma rich in growth factors (PRGF).

Science.gov (United States)

Anitua, Eduardo; Troya, María; Zalduendo, Mar; Orive, Gorka

2015-02-01

The prevalence and incidence of trauma-related injuries, coronary heart disease and other chronic diseases increase dramatically with age. This population sector is therefore a regular consumer of different types of drugs that may affect platelet aggregation and the coagulation cascade. We have evaluated whether the consumption of acetylsalicylic acid, acenocoumarol, glucosamine sulfate and chondroitin sulfate, and therefore their presence in blood, could interfere with the preparation and biological outcomes of plasma rich in growth factors (PRGF). Clotting time, clot retraction and platelet activation of PRGF was evaluated. PRGF growth factor content and the release of different biomolecules by tendon fibroblasts were also quantified, as well as cell proliferation and cell migration. The preparation and biological potential of PRGF is not affected by the intake of the evaluated drugs, and solely its angiogenic potential and its capacity to induce HA and fibronectin synthesis, is reduced in patients taking anti-coagulants.

STUDY OF ACUTE KIDNEY INJURY IN SNAKE BITE PATIENTS

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Suma Dasaraju

2017-04-01

Full Text Available BACKGROUND Snake venom is well known to cause toxic damage to the kidneys (Schreiner and Maher, 1965. This study is an attempt to evaluate the snakebite-induced Acute Kidney Injury (AKI. MATERIALS AND METHODS 50 patients with snakebite-induced acute kidney injury were selected randomly and their clinical profile was assessed. Acute kidney injury was evaluated using noninvasive laboratory methods. Inclusion Criteria- 1. History of snakebite; 2. Presence of AKI. Exclusion Criteria- Pre-existing renal diseases, after establishing the diagnosis, patients were started on conservative treatment including ASV, blood/blood products and haemodialysis as required. RESULTS Out of 50 patients included in the study, majority of them were males (62% with mean age of presentation 43.8 ± 12.63 years. The mean interval between snakebite and presentation to hospital was 15.37 hours. In them, 98% patients presented with local signs of inflammation, 52% of patients presented with coagulation abnormality and 60% with decreased urine output. Comparison between good outcome (recovered from AKI and poor outcome (not recovered from AKI shows significant pvalue for ‘lapse of time in hours’ in presenting to the hospital after snakebite (p value 0.005 and ‘alternative treatment taken’ before coming to the hospital (p value 0.001. CONCLUSION Poisonous snakebites have common manifestations of cellulitis, abnormal coagulation profile and decreased urine output. Overall mortality due to snakebite-induced AKI is 6%. Patients who did not recover from AKI had lapse of time in presenting to the hospital and abnormal coagulation profile.

Characteristic appearances of fundus autofluorescence in treatment-naive and active polypoidal choroidal vasculopathy: a retrospective study of 170 patients.

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Zhao, Xinyu; Xia, Song; Chen, Youxin

2018-06-01

To investigate the characteristic appearances of fundus autofluorescence (FAF) in patients with treatment-naive and active polypoidal choroidal vasculopathy (PCV). Cases with the diagnosis of treatment-naive and active PCV from November 2012 to May 2017 at Peking Union Medical College Hospital were retrospectively reviewed. All patients underwent comprehensive ophthalmologic examination. Autofluorescence (AF) findings were described at the retinal sites of the corresponding lesions identified and diagnosed using indocyanine green angiography and spectral-domain optical coherence tomography. One hundred seventy patients with 192 affected eyes were included. The logMAR BCVA of the patients were 0.53 ± 0.28. The six AF patterns of 243 polypoidal lesions were confluent hypo-AF with hyper-AF ring (49.8%), confluent hypo-AF (22.6%), hyper-AF with hypo-AF ring (3.7%), granular hypo-AF (7.0%), blocked hypo-AF due to hemorrhage (8.6%), and polyps without apparent AF changes (8.2%). For 146 branching vascular networks (BVNs), 97.3% were granular hypo-AF, and others were blocked hypo-AF due to hemorrhage. In eyes with treatment-naive and active PCV, the polypoidal lesions and BVNs induce characteristic FAF changes. FAF images provide reliable adjunct reference for the diagnosis of PCV.

Seagrass proliferation precedes mortality during hypo-salinity events: a stress-induced morphometric response.

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Catherine J Collier

Full Text Available Halophytes, such as seagrasses, predominantly form habitats in coastal and estuarine areas. These habitats can be seasonally exposed to hypo-salinity events during watershed runoff exposing them to dramatic salinity shifts and osmotic shock. The manifestation of this osmotic shock on seagrass morphology and phenology was tested in three Indo-Pacific seagrass species, Halophila ovalis, Halodule uninervis and Zostera muelleri, to hypo-salinity ranging from 3 to 36 PSU at 3 PSU increments for 10 weeks. All three species had broad salinity tolerance but demonstrated a moderate hypo-salinity stress response--analogous to a stress induced morphometric response (SIMR. Shoot proliferation occurred at salinities <30 PSU, with the largest increases, up to 400% increase in shoot density, occurring at the sub-lethal salinities <15 PSU, with the specific salinity associated with peak shoot density being variable among species. Resources were not diverted away from leaf growth or shoot development to support the new shoot production. However, at sub-lethal salinities where shoots proliferated, flowering was severely reduced for H. ovalis, the only species to flower during this experiment, demonstrating a diversion of resources away from sexual reproduction to support the investment in new shoots. This SIMR response preceded mortality, which occurred at 3 PSU for H. ovalis and 6 PSU for H. uninervis, while complete mortality was not reached for Z. muelleri. This is the first study to identify a SIMR in seagrasses, being detectable due to the fine resolution of salinity treatments tested. The detection of SIMR demonstrates the need for caution in interpreting in-situ changes in shoot density as shoot proliferation could be interpreted as a healthy or positive plant response to environmental conditions, when in fact it could signal pre-mortality stress.

Commonly Used Dietary Supplements on Coagulation Function during Surgery

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Chong-Zhi Wang

2015-07-01

Full Text Available Background: Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information about the potential complications of dietary supplements during perioperative management is important for physicians. Methods: Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Results: Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John’s wort, and valerian and four other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins. Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John’s wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. Conclusions: To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet

Commonly Used Dietary Supplements on Coagulation Function during Surgery

Science.gov (United States)

Wang, Chong-Zhi; Moss, Jonathan; Yuan, Chun-Su

2015-01-01

Abstract Background Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information about the potential complications of dietary supplements during perioperative management is important for physicians. Methods Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Results Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John’s wort, and valerian) and four other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John’s wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. Conclusions To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are

Commonly Used Dietary Supplements on Coagulation Function during Surgery.

Science.gov (United States)

Wang, Chong-Zhi; Moss, Jonathan; Yuan, Chun-Su

2015-09-01

Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information of potential complications of dietary supplements during perioperative management is important for physicians. Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John's wort, and valerian) and 4 other dietary supplements (coenzyme Q 10 , glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John's wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are difficult to predict, it is prudent to advise their

Effect of nano-scale curvature on the intrinsic blood coagulation system

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Kushida, Takashi; Saha, Krishnendu; Subramani, Chandramouleeswaran; Nandwana, Vikas; Rotello, Vincent M.

2014-01-01

The intrinsic coagulation activity of silica nanoparticles strongly depends on their surface curvature. Nanoparticles with higher surface curvature do not denature blood coagulation factor XII on its surface, providing a coagulation ‘silent’ surface, while nanoparticles with lower surface curvature shows denaturation and concomitant coagulation. PMID:25341004

Percutaneous artery embolization of bleeding rectus sheath hematomas in hemodynamically unstable patients: Outcomes of 43 patients in a tertiary referral hospital

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Alberto Cereda

2017-11-01

Full Text Available Rectus sheath hematoma (RSH is an uncommon cause of abdominal pain that can lead to life-threatening bleeding, particularly in elderly patients receiving anticoagulation therapy. Type III RSHs, based on computer tomography (CT evaluation, is characterized by active bleeding with intramuscular or intraperitoneal extension and hemodynamic instability. Medical contemporary knowledge of this condition is contentious and overall 20% of acute mortality has been reported. The purpose of this study was to retrospectively review our experience and outcomes in the management of RSHs treated with percutaneous arterial embolization of the epigastric vessels. We retrospectively analyzed 43 patients with RSH type III, submitted to percutaneous epigastric artery embolization from 2007 to 2015. Percutaneous arterial embolization was feasible and successful in patients with a high burden of comorbidities and receiving anticoagulation therapy. There was no acute mortality and a late mortality at 3 months of 9.1% (4/43 was not directly related to RSHs or arterial embolization. Patients with late mortality had lower ejection fraction, prolonged PTT, greater RDW and warfarin in overlapping with low-molecular-weight heparins. Transcatheter arterial embolization of the epigastric vessels was safe, feasible and effective in stopping the bleeding. Despite anti-platelets/anti-coagulation therapy and a high burden of comorbidities, there was no acute mortality related to RSH.

Extracranial Facial Nerve Schwannoma Treated by Hypo-fractionated CyberKnife Radiosurgery

OpenAIRE

Sasaki, Ayaka; Miyazaki, Shinichiro; Hori, Tomokatsu

2016-01-01

Facial nerve schwannoma is a rare intracranial tumor. Treatment for this benign tumor has been controversial. Here, we report a case of extracranial facial nerve schwannoma treated successfully by hypo-fractionated CyberKnife (Accuray, Sunnyvale, CA) radiosurgery?and discuss the efficacy of this treatment. A 34-year-old female noticed a swelling in her right mastoid process. The lesion enlarged over a seven-month period, and she experienced facial spasm on the right side. She was diagnosed wi...

Treatment of waste water by coagulation and flocculation using biomaterials

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Muruganandam, L.; Saravana Kumar, M. P.; Jena, Amarjit; Gulla, Sudiv; Godhwani, Bhagesh

2017-11-01

The present study deals with the determination of physical and chemical parameters in the treatment process of waste water by flocculation and coagulation processes using natural coagulants and assessing their feasibility for water treatment by comparing the performance with each other and with a synthetic coagulant. Initial studies were done on the synthetic waste water to determine the optimal pH and dosage, the activity of natural coagulant, followed by the real effluent from tannery waste. The raw tannery effluent was bluish-black in colour, mildly basic in nature, with high COD 4000mg/l and turbidity in the range 700NTU, was diluted and dosed with organic coagulants, AloeVera, MoringaOleifera and Cactus (O.ficus-indica). The study observed that coagulant Moringa Oleifera of 15 mg/L dose at 6 pH gave the best reduction efficiencies for major physicochemical parameters followed by Aloe Vera and Cactus under identical conditions. The study reveals that the untreated tannery effluents can be treated with environmental confirmative naturally occurring coagulants.

Coagulation chemistries for silica removal from cooling tower water.

Energy Technology Data Exchange (ETDEWEB)

Nyman, May Devan; Altman, Susan Jeanne; Stewart, Tom

2010-02-01

The formation of silica scale is a problem for thermoelectric power generating facilities, and this study investigated the potential for removal of silica by means of chemical coagulation from source water before it is subjected to mineral concentration in cooling towers. In Phase I, a screening of many typical as well as novel coagulants was carried out using concentrated cooling tower water, with and without flocculation aids, at concentrations typical for water purification with limited results. In Phase II, it was decided that treatment of source or make up water was more appropriate, and that higher dosing with coagulants delivered promising results. In fact, the less exotic coagulants proved to be more efficacious for reasons not yet fully determined. Some analysis was made of the molecular nature of the precipitated floc, which may aid in process improvements. In Phase III, more detailed study of process conditions for aluminum chloride coagulation was undertaken. Lime-soda water softening and the precipitation of magnesium hydroxide were shown to be too limited in terms of effectiveness, speed, and energy consumption to be considered further for the present application. In Phase IV, sodium aluminate emerged as an effective coagulant for silica, and the most attractive of those tested to date because of its availability, ease of use, and low requirement for additional chemicals. Some process optimization was performed for coagulant concentration and operational pH. It is concluded that silica coagulation with simple aluminum-based agents is effective, simple, and compatible with other industrial processes.

Comparison of the Performance of Corn Starch Coagulant Aid Accompany with Alum, Polyaluminum Chloride and Ferric Chloride Coagulants in Turbidity Removal from Water

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Leila Mosleh

2014-09-01

Full Text Available Background: The most important process in water treatment plant is coagulation and flocculation. Regular chemical coagulant which used in Iran are aluminum sulfate (Alum and ferric chloride. Chemical coagulants have hazardous effect on human health and their cost is high for developing country. The purpose of this study was to evaluate the comparison of chemical coagulants accompany with corn starch as a coagulant aid, for the turbidity removal from water. Methods: This study was accomplished in pilot-scale with synthetic turbid water using clay. In this research, initial turbidity of 250 and 500 NTU was experimented. Chemical coagulant dose during the experiment was 1, 2 and 5 ppm and natural coagulant dose was 0, 0.1, 0.3, 0.5 and 0.7 ppm. Results: The results showed that maximum removal efficiency of turbidity in initial turbidity of 250 NTU belonged to poly aluminum chloride with 5 ppm dosage and corn starch with 0.7 ppm dosage which removed and reduced the initial turbidity to 98.48% and 3.73 NTU, respectively. Moreover, in initial turbidity of 500 NTU the maximum removal efficiency was 98.52% which belonged to ferric chloride and corn starch (5 and 0.7 ppm respectively and reduced the initial turbidity to 7.4 NTU. Conclusions: The results of this study showed that using natural coagulant aid reduce the chemical coagulant consumption, and also does not have significant effect on pH range and reduce the health risks. While huge amount of required polyelectrolytes for water treatment plant imported to the country and the production of corn starch in our country is high, it is hope that the results of this project can be used in industrial scale.

Exploring the Experiences of People With Hypo- and Hyperthyroidism

DEFF Research Database (Denmark)

Nexø, Mette A; Watt, Torquil; Cleal, Bryan

2015-01-01

interpretative phenomenological analysis (IPA) as a theoretical frame and analytical approach and identified three superordinate themes: losing control over mental and physical states, ambiguous signs of disease, and negotiating sickness. We discuss the findings in the context of the recent literature on chronic......Thyroid diseases evoke a complex range of psychological and physical symptoms. The psychosocial aspects of living with diseases causing hypo- or hyperthyroidism are poorly understood. In this article, we report the findings of a qualitative interview study in which we explored the lived experiences...... illness and argue that these themes play an important role in the conceptualization and management of thyroid diseases....

PATIENT-REPORTED OUTCOMES (PROs): PUTTING THE PATIENT PERSPECTIVE IN PATIENT-CENTERED OUTCOMES RESEARCH

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Snyder, Claire F.; Jensen, Roxanne E.; Segal, Jodi B.; Wu, Albert W.

2013-01-01

Patient-centered outcomes research (PCOR) aims to improve care quality and patient outcomes by providing information that patients, clinicians, and family members need regarding treatment alternatives, and emphasizing patient input to inform the research process. PCOR capitalizes on available data sources and generates new evidence to provide timely and relevant information and can be conducted using prospective data collection, disease registries, electronic medical records, aggregated results from prior research, and administrative claims. Given PCOR’s emphasis on the patient perspective, methods to incorporate patient-reported outcomes (PROs) are critical. PROs are defined by the U.S. Food & Drug Administration as “Any report coming directly from patients… about a health condition and its treatment.” However, PROs have not routinely been collected in a way that facilitates their use in PCOR. Electronic medical records, disease registries, and administrative data have only rarely collected, or been linked to, PROs. Recent technological developments facilitate the electronic collection of PROs and linkage of PRO data, offering new opportunities for putting the patient perspective in PCOR. This paper describes the importance of and methods for using PROs for PCOR. We (1) define PROs; (2) identify how PROs can be used in PCOR, and the critical role of electronic data methods for facilitating the use of PRO data in PCOR; (3) outline the challenges and key unanswered questions that need to be addressed for the routine use of PROs in PCOR; and (4) discuss policy and research interventions to accelerate the integration of PROs with clinical data. PMID:23774513

Comparison of Electrocoagulation and Chemical Coagulation Processes in Removing Reactive red 196 from Aqueous Solution

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Ali Assadi

2016-06-01

Full Text Available Background: Conventional chemical coagulation is considered as an old method to dye and COD removal in textile effluent. Electrocoagulation (EC process is a robust method to achieve maximum removal. Methods: This study was designed to compare the result of operational parameters including optimum pH and coagulant concentration for chemical coagulation with ferric chloride and alum also, voltage, electrolysis time, initial pH, and conductivity for EC with iron electrodes to remove reactive red 196 (RR 196. Results: The outcomes show that ferric chloride and alum at optimum concentration were capable of removing dye and COD by 79.63 % and 84.83% and 53% and 55%, respectively. In contrast, EC process removed the dye and COD by 99.98% and 90.4%, respectively. Conclusion: The highest treatment efficiency was obtained by increasing the voltage, electrolysis time, pH and conductivity. Increase initial dye concentration reduces removal efficiency. Ultimately, it could be concluded that EC technology is an efficient procedure for handling of colored industrial wastewaters.

Intraventricular hemorrhage in preterm infants and coagulation--ambivalent perspectives?

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Kuperman, Amir A; Brenner, Benjamin; Kenet, Gili

2013-01-01

Intraventricular hemorrhage (IVH) is a major complication of preterm birth, and large hemorrhages may yield significant future disability. During the last few decades, the survival of preterm infants has increased dramatically. Nevertheless, morbidity is still a major problem especially for very young and extremely low birth weight infants. As both, mortality and incidence of morbidities known to influence outcome, show a weekly decline with increasing gestational age, prematurity and low birth weight have been identified as major risk factors for IVH occurrence. This stems probably from the increased vulnerability of the premature germinal matrix as well as the physiologically impaired hemostasis, demonstrated in neonates. The hypothesis that a severe coagulation deficiency in the premature newborn could be a major contributing factor for IVH has been suggested, and small open label interventional studies targeting the premature coagulation system have been conducted with ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII and prothrombin complex concentrate. Nevertheless, potential venous origin of hemorrhages, which may be related to thrombophilic risk factors, has also been discussed. The following manuscript will focus upon IVH pathogenesis and address potential therapies. Copyright © 2013 Elsevier Ltd. All rights reserved.

Coagulation and inflammation

NARCIS (Netherlands)

van der Poll, T.

2001-01-01

Severe infection induces both activation of the coagulation system and multiple other inflammatory mediator cascades. This concise review summarizes the current knowledge of mechanisms that are considered to contribute to the procoagulant response to sepsis. Furthermore, evidence is discussed that

Evaluation of cardiac denervation in patients with long-standing diabetes

International Nuclear Information System (INIS)

Khurram, M.; Khar, Hamama-tul-Bushra; Malik, M.F. Fazal-ur-Rehman; Javed, S.; Hassan, Z.; Minhas, Z.; Goraya, M.F.; Shakoor, A.

2002-01-01

Objective: Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypo glycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Methods: Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group 1(13 males, 12 females; mean age 33.08 years) included those who received insulin, and Group II patients (12 males, 13 females; mean age 54.68 years) who received oral hypo glycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsava response. Results: At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76 % of Group II patients. A significantly high number of patients treated with oral hypo glycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin (p < 0.05). Conclusion: Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypo glycemic agents. (author)

Lipoproteins as modulators of atherothrombosis: From endothelial function to primary and secondary coagulation.

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Ouweneel, Amber B; Van Eck, Miranda

2016-07-01

Atherothrombosis is a complication of atherosclerosis that causes acute cardiovascular events such as myocardial infarction and stroke. Circulating lipid levels are highly correlated with atherosclerotic plaque development. In addition, experimental evidence suggests that lipids also directly influence thrombosis and influence the risk and the outcome of acute cardiovascular events. Plasma lipoproteins influence three aspects important to atherothrombosis: endothelial function, platelet aggregation (primary coagulation) and secondary coagulation. Overall, VLDL, LDL and oxLDL promote thrombus formation, whereas HDL shows antithrombotic actions. In this review we will address the current knowledge about modulation of atherothrombosis by lipoproteins, summarizing findings from in vitro and in vivo animal studies, as well as from observational and interventional studies in humans. We will conclude with future perspectives for lipid modulation in the prevention of atherothrombosis. Copyright © 2015 Elsevier Inc. All rights reserved.

Bio-responsive polymer hydrogels homeostatically regulate blood coagulation.

Science.gov (United States)

Maitz, Manfred F; Freudenberg, Uwe; Tsurkan, Mikhail V; Fischer, Marion; Beyrich, Theresa; Werner, Carsten

2013-01-01

Bio-responsive polymer architectures can empower medical therapies by engaging molecular feedback-response mechanisms resembling the homeostatic adaptation of living tissues to varying environmental constraints. Here we show that a blood coagulation-responsive hydrogel system can deliver heparin in amounts triggered by the environmental levels of thrombin, the key enzyme of the coagulation cascade, which--in turn--becomes inactivated due to released heparin. The bio-responsive hydrogel quantitatively quenches blood coagulation over several hours in the presence of pro-coagulant stimuli and during repeated incubation with fresh, non-anticoagulated blood. These features enable the introduced material to provide sustainable, autoregulated anticoagulation, addressing a key challenge of many medical therapies. Beyond that, the explored concept may facilitate the development of materials that allow the effective and controlled application of drugs and biomolecules.

Coagulation parameters as a guide for fresh frozen plasma transfusion practice: A tertiary hospital experience

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Wan Haslindawani W

2010-01-01

Full Text Available Introduction: The appropriate use of blood and blood products means the transfusion of safe blood products only to treat a condition leading to significant morbidity or mortality, which cannot be prevented or managed effectively by other means. The safety and effectiveness of transfusion depend on the appropriate clinical use of blood and blood products. This study was conducted to review the practice of fresh frozen plasma usage (FFP for transfusion, based on the coagulation profile, requested by various departments in the Hospital Universiti Sains Malaysia (HUSM. Methodology: A retrospective review of blood bank records and coagulation profile results of the patients given FFP from October to December 2006, in Hospital USM was undertaken. The criteria set by the College of American Pathologists in 1994, were used as the guidelines. Results: One thousand six hundred and ninety-eight units of FFP were used during this study period. Only 806 (47.47% FFP units were deemed appropriate. 20.38% were based on studies without any coagulation tests prior to transfusion and 21.13% were transfused for mild prolongation of coagulation test results. About 6.41% requested FFP in the setting of normal coagulation results. Conclusion: Our results showed that a significant proportion of the FFP transfusion was not guided by the coagulation profile. We recommend that a continuous education on FFP transfusion may help to guide the appropriate request for FFP.

An in vitro analysis of the effect of acidosis on coagulation in chronic disease states - a thromboelastograph study.

Science.gov (United States)

White, Hayden; Bird, Robert; Sosnowski, Kellie; Jones, Mark

2016-06-01

Thrombosis is a complication of many chronic illnesses. Chronic obstructive pulmonary disease (COPD) and diabetes mellitus are common medical conditions frequently associated with a hypercoagulable state. Acidaemia has been shown to reduce coagulation. COPD and diabetes mellitus during acute deterioration can present with a severe acidaemia. The impact of this acidaemia on coagulation is poorly studied. Patients presenting with a diagnosis of diabetic ketoacidosis or type II respiratory failure from COPD and a pH of less than 7.2 were included in our study. A coagulation screen and a thromboelastograph (TEG) were performed on admission and 24 hours later. The mean pH on admission was 7.07 and mean base excess was -16.3. The activated partial thromboplastin time was associated with pH change but remained within the normal range (26-41 s). All other coagulation and TEG parameters failed to show evidence of association (p>0.05). In the two models of non-haemorrhagic acidosis investigated, coagulation was not altered by the changes in pH. More work is needed to understand the complex relationship between factors affecting coagulation in individual disease processes. © 2016 Royal College of Physicians.

Potential Use of Polyaluminium Chloride and Tobacco Leaf as Coagulant and Coagulant Aid in Post-Treatment of Landfill Leachate

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Nurfarahim Rusdizal

2015-12-01

Full Text Available A study was conducted to treat stabilized leachate by applying polyaluminium chloride (PAC and tobacco leaf extract as a coagulant and coagulant aid. Experimental results indicated that the tobacco leaves were positively charged. The removal rate of the chemical oxygen demand, using 1500 mg/L PAC as a sole coagulant, was approximately 63% and increased to 91% when 1000 mg/L PAC was mixed with 1000 mg/L tobacco leaf. Additionally, 1500 mg/L PAC with 250 - 1000 mg/L tobacco leaf and 54% ammoniacal nitrogen was removed, compared with only 46% reduction using 1500 mg/L with only 46% reduction.

Implementation of a microcontroller-based semi-automatic coagulator.

Science.gov (United States)

Chan, K; Kirumira, A; Elkateeb, A

2001-01-01

The coagulator is an instrument used in hospitals to detect clot formation as a function of time. Generally, these coagulators are very expensive and therefore not affordable by a doctors' office and small clinics. The objective of this project is to design and implement a low cost semi-automatic coagulator (SAC) prototype. The SAC is capable of assaying up to 12 samples and can perform the following tests: prothrombin time (PT), activated partial thromboplastin time (APTT), and PT/APTT combination. The prototype has been tested successfully.

Coagulation mechanism of salt solution-extracted active component in Moringa oleifera seeds.

Science.gov (United States)

Okuda, T; Baes, A U; Nishijima, W; Okada, M

2001-03-01

This study focuses on the coagulation mechanism by the purified coagulant solution (MOC-SC-PC) with the coagulation active component extracted from M. oleifera seeds using salt solution. The addition of MOC-SC-PC tap water formed insoluble matters. This formation was responsible for kaolin coagulation. On the other hand, insoluble matters were not formed when the MOC-SC-PC was added into distilled water. The formation was affected by Ca2+ or other bivalent cations which may connect each molecule of the active coagulation component in MOC-SC-PC and form a net-like structure. The coagulation mechanism of MOC-SC-PC seemed to be an enmeshment of Kaolin by the insoluble matters with the net-like structure. In case of Ca2+ ion (bivalent cations), at least 0.2 mM was necessary for coagulation at 0.3 mgC l-1 dose of MOC-SC-PC. Other coagulation mechanisms like compression of double layer, interparticle bridging or charge neutralization were not responsible for the coagulation by MOC-SC-PC.

Effect of batroxobin combine with ginkgo-damole injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness

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Xiang Xu

2017-11-01

Full Text Available Objective: To study the effects of combined use of Batroxobin and Ginkgo Leaf Extract and Dipyridamole Injection on hemodynamics, coagulation function, fibrinolytic function and related factors in patients with sudden deafness. Methods: A total of 94 patients with sudden deafness in our hospital were selected, and divided them into control group and observation group randomly, 47 cases in each group. All patients were given 10BU batroxobin injection intravenous drip after admission every other day; And the patients of observation group were given intravenous drip of 30ml ginkgo-damole injection, 1 time a day. The hemodynamics, coagulation function, fibrinolytic function and related factors were detected and compared between the two groups before and after treatment. Results: Before treatment, there was no statistical difference in hemodynamics, coagulation function, fibrinolytic function and related factors between the two groups; After treatment, the levels of WBV and PV in the control group was (5.21±0.58 mPa/s and (1.78±0.32 mPa/s, and the observation group was (4.13±0.47 mPa/s and (1.31±0.26 mPa/s, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups; The levels of PT, APTT, TT and PF was (19.22±3.98 s, (43.57±9.88 s, (15.64±3.27 s and (58.22±10.58 μg/L, and the observation group was (23.97±4.82 s, (52.49±10.38 s, (20.59±4.15 s and (41.03±8.46 μg/L, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups; The levels of Fib, D-dimer and FDP was (4.52±0.93 g/L, (6.53±1.88 mg/L and (8.17±2.34 μg/mL, and the observation group was (3.13±0.75 g/L, (9.75±2.14 mg/L, (13.52±2.58 μg/ mL, compared with the same group before treatment, there were statistical difference, and there was also statistical difference between the two groups; The serum

Intraventricular hemorrhage in preterm infants: coagulation perspectives.

Science.gov (United States)

Kuperman, Amir A; Kenet, Gili; Papadakis, Emmanuel; Brenner, Benjamin

2011-10-01

It has long been considered that a severe coagulation deficiency in premature newborns could be a major contributing factor in the occurrence of intraventricular hemorrhage (IVH). High-grade IVH has also been shown to coincide with severe derangement of coagulation in extremely low birth weight infants. This review focuses on the relevance of the physiologically developing immature hemostatic system to IVH, and the potential benefit of agents affecting hemostasis for IVH therapy or prevention in preterm infants. The findings of small, open-label interventional studies on the effect of ethamsylate, vitamin K, fresh frozen plasma, recombinant activated factor VII, and prothrombin complex concentrate on the premature coagulation system will be reviewed. © Thieme Medical Publishers.

The Coagulant Type Influence on Removal Efficiency of 5- and 6-Ring Pahs During Water Coagulation Process

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Nowacka Anna

2014-12-01

Full Text Available The article presents results on investigation of the removal efficiency of selected 5- and 6-ring polycyclic aromatic hydrocarbons (benzo[a]pyrene, benzo[b]fluoranthene, benzo[k]fluoranthene, benzo[j]fluoranthene, benzo[g,h,i]perylene, indeno[1,2,3-cd]pyrene, dibenzo[a,h]anthracene from water during coagulation and sedimentation process. Two pre-hydrolyzed aluminum coagulants: PAX XL 19H and FLOKOR 105V were chosen for research. Process was carried out at optimum process parameters: rapid-mixing - 3 min at the rotational speed of 200 rpm, slow mixing - 10 min at 30 rpm, sedimentation - 60 min. The removal effectiveness was dependant on coagulant type and its composition. Better results in the removal of 5-and 6-ring PAHs were obtained after application of FLOKOR 105V (lower aluminum content than after using PAX XL 19H.

[Role and clinical significance of coagulation and inflammatory factors in moderate and severe ovarian endometriosis].

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Lin, Q; Ding, S J; Zhu, T H; Li, T T; Huang, X F; Zhang, X M

2018-03-25

Objective: To determine the levels of coagulation and inflammatory factors in women with moderate and severe ovarian endometriosis so as to investigate the possible role of coagulation and inflammatory factors in the pathogenesis, diagnosis and treatment of this disease. Methods: From June 2015 and June 2017, clinical data of 366 patients with pathologically diagnosed moderate and severe ovarian endometriosis (case group) and 244 patients with pathologically diagnosed benign ovarian cysts (control group) in Women's Hospital of Zhejiang University School of Medicine were retrospectively analyzed. The levels of coagulation indicators, inflammatory factors and serum tumor markers were measured. Then, the values of these indicators in diagnosis of endometriosis were analyzed. Results: (1) The levels of plasma prothrombin time (PT) and thrombin time (TT) in patients with ovarian endometriosis [median: 12.8 s (range: 12.4-13.2 s) and 15.5 s (range: 15.1-15.9 s), respectively] were significantly shorter than those with benign ovarian cysts [median: 13.0 s (range: 12.5-13.4 s) and 15.7 s (range: 15.3-16.1 s), respectively; all P endometriosis were significantly higher than those with benign ovarian cysts [median: 2.8 g/L (range: 2.6-3.2 g/L) and 0.6 mg/L (range: 0.4-1.2 mg/L), respectively; P =0.000]. Moreover, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio [PLR; median: 2.3 (range: 1.8-3.1) and 144 (range: 113-179), respectively] in patients with ovarian endometriosis were significantly higher than those with benign ovarian cysts [median: 2.1 (range: 1.6-2.8) and 128 (range: 104-165), respectively; P endometriosis, the levels of PT were significantly shorter in stage Ⅳ endometriosis than that in stage Ⅲ endometriosis ( P endometriosis were significantly higher than those in patients with stage Ⅲ endometriosis ( P endometriosis, and the detection of coagulation and inflammatory factors may be have important clinical significance for the

Teleophthalmology: improving patient outcomes?

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Sreelatha OK

2016-02-01

Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

Optimum coagulant forecasting by modeling jar test experiments using ANNs

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Haghiri, Sadaf; Daghighi, Amin; Moharramzadeh, Sina

2018-01-01

Currently, the proper utilization of water treatment plants and optimizing their use is of particular importance. Coagulation and flocculation in water treatment are the common ways through which the use of coagulants leads to instability of particles and the formation of larger and heavier particles, resulting in improvement of sedimentation and filtration processes. Determination of the optimum dose of such a coagulant is of particular significance. A high dose, in addition to adding costs, can cause the sediment to remain in the filtrate, a dangerous condition according to the standards, while a sub-adequate dose of coagulants can result in the reducing the required quality and acceptable performance of the coagulation process. Although jar tests are used for testing coagulants, such experiments face many constraints with respect to evaluating the results produced by sudden changes in input water because of their significant costs, long time requirements, and complex relationships among the many factors (turbidity, temperature, pH, alkalinity, etc.) that can influence the efficiency of coagulant and test results. Modeling can be used to overcome these limitations; in this research study, an artificial neural network (ANN) multi-layer perceptron (MLP) with one hidden layer has been used for modeling the jar test to determine the dosage level of used coagulant in water treatment processes. The data contained in this research have been obtained from the drinking water treatment plant located in Ardabil province in Iran. To evaluate the performance of the model, the mean squared error (MSE) and correlation coefficient (R2) parameters have been used. The obtained values are within an acceptable range that demonstrates the high accuracy of the models with respect to the estimation of water-quality characteristics and the optimal dosages of coagulants; so using these models will allow operators to not only reduce costs and time taken to perform experimental jar tests

Investigational drugs for coagulation disorders.

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Mannucci, Pier Mannuccio; Mancuso, Maria Elisa

2013-08-01

The current standard treatment in persons with hemophilia (PWH) is prophylaxis, given intravenously twice or thrice weekly, which is associated with a non negligible burden on patients' quality of life. Therefore the main attempts aiming to improve the management of PWH are targeted towards the development of a new generation of coagulation factors endowed with properties facilitating prophylaxis and/or a better control of bleeding. This article summarizes the main results obtained so far in the development of new antihemophilic products, and emphasizes the formidable requirements imposed upon by regulatory agencies to get marketing authorization for new drugs, which make progress in this field difficult. Published literature on new molecules for replacement treatment in hemophilia A and B has been retrieved by using PubMed search and all ongoing clinical trials have been looked for online. New molecules are usually engineered to have a longer plasma half-life but also in some instances a higher potency. The prolongation of half-life may be obtained by using sustained release delivery vehicles, by chemical modification or by creating fusion proteins. Factors VIII, IX and VII have been variably modified in order to obtain improved coagulation products and results from Phase I/II studies are encouraging, particularly for factor IX. However, Phase III studies that should provide evidence on efficacy and effectiveness more cogent for clinical use are still ongoing and results are not yet available.

Disseminated intravascular coagulation in meningococcal sepsis. Case 7

NARCIS (Netherlands)

Zeerleder, S.; Zürcher Zenklusen, R.; Hack, C. E.; Wuillemin, W. A.

2003-01-01

We report on a man (age: 49 years), who died from severe meningococcal sepsis with disseminated intravascular coagulation (DIC), multiple organ dysfunction syndrome and extended skin necrosis. We discuss in detail the pathophysiology of the activation of coagulation and fibrinolysis during sepsis.

Two-incision laparoscopic appendectomy for a severe hemophilia A child patient with coagulation factor VII deficiency: Case report and review of literature.

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He, Jin Peng; Feng, Jie Xiong

2017-10-01

The main complication of patients with severe hemophilia is recurrent bleeding events that usually affected musculoskeletal contractures. And replacement therapy methods were continuously improved to minimize adverse impacts brought by those complications. However, only several cases reported about the appendectomy for hemophilia A. We report a case of acute appendicitis treated by two-incision laparoscopy in a boy with hemophilia A and coagulation factor VII deficiency for the first time. An 8y7m-old Chinese boy presented with half a day of right sided abdominal pain, fever, nausea, and vomiting. He received a computed tomography (CT) scan which revealed an enlarged appendix, thickened wall and appendiceal fecalith, and had received a conservative anti-bacterial treatment for his acute appendicitis but failed. He was diagnosed with hemophilia A and coagulation factor VII deficiency. Two-incision laparoscopic appendectomy was made in success with a careful management of perioperative period. We monitored the clotting factor FVIII level and gave him a replacement therapy. The patient had an uneventful recovery. It is important to exclude intraabdominal or retroperitoneal hemorrhage in patients suffering from hemophilia and acute abdominal pain. Pre-operative evaluation of validity of the FVIII replacement therapy is another effective strategy to assess the safety and feasibility of applying an operation procedure. The two-incision laparoscopic appendectomy is an effective treatment for this kind of patients for its minimal trauma and fast recovery characteristics. Our report shows that laparoscopic appendectomy is feasible in a child suffering from hemophilia after adequate blood clotting factor replacement treatment.

Interplay between coagulation and vascular inflammation in sickle cell disease

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Sparkenbaugh, Erica; Pawlinski, Rafal

2013-01-01

Sickle cell disease is the most common inherited hematologic disorder that leads to the irreversible damage of multiple organs. Although sickling of red blood cells and vaso-occlusion are central to the pathophysiology of sickle cell disease the importance of hemolytic anemia and vasculopathy has been recently recognized. Hypercoagulation state is another prominent feature of sickle cell disease and is mediated by activation of both intrinsic and extrinsic coagulation pathways. Growing evidence demonstrates that coagulation may not only contribute to the thrombotic complications, but also to vascular inflammation associated with this disease. This article summarizes the role of vascular inflammation and coagulation activation, discusses potential mechanisms responsible for activation of coagulation and reviews recent data demonstrating the crosstalk between coagulation and vascular inflammation in sickle cell disease. PMID:23593937

Factors contributing to the disturbance of coagulation and fibrinolysis in dengue virus infection

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Yung-Chun Chuang

2013-01-01

Full Text Available Hemorrhage is one of the hallmarks of dengue hemorrhagic fever. However, the mechanisms that cause hemorrhage are unclear. In this review we focus on the possible factors that may be involved in the disturbance of coagulation and fibrinolysis during dengue virus (DENV infection. Factors such as autoantibodies and cytokines induced by DENV infection as well as hemostatic molecules expressed on DENV-infected cells, and DENV viral proteins may all contribute to the defect of hemostasis during DENV infection. It is the combination of these viral and host factors that may tilt the balance of coagulation and fibrinolysis toward bleeding in dengue patients.

Hypo-analytic structures local theory (PMS-40)

CERN Document Server

Treves, François

2014-01-01

In Hypo-Analytic Structures Franois Treves provides a systematic approach to the study of the differential structures on manifolds defined by systems of complex vector fields. Serving as his main examples are the elliptic complexes, among which the De Rham and Dolbeault are the best known, and the tangential Cauchy-Riemann operators. Basic geometric entities attached to those structures are isolated, such as maximally real submanifolds and orbits of the system. Treves discusses the existence, uniqueness, and approximation of local solutions to homogeneous and inhomogeneous equations and delimits their supports. The contents of this book consist of many results accumulated in the last decade by the author and his collaborators, but also include classical results, such as the Newlander-Nirenberg theorem. The reader will find an elementary description of the FBI transform, as well as examples of its use. Treves extends the main approximation and uniqueness results to first-order nonlinear equations by means of ...

Coagulation and oxidative stress plasmatic levels in a type 2 diabetes population.

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Barillari, Giovanni; Fabbro, Elisabetta; Pasca, Samantha; Bigotto, Enrico

2009-06-01

Type 2 diabetes mellitus (DM2) is a metabolic disorder characterized by relative insulin deficiency, insulin resistance and hyperglycemia. DM2 improperly managed can cause severe complications such as renal failure, blindness or arterial disease. In addition to serious complications due to DM2, in the past 20 years, several studies have demonstrated the association between DM2, insulin resistance and prothrombotic risk. In our study, we wanted to evaluate the correlation between coagulation factor levels, oxidative plasmatic levels and DM2. We considered 20 DM2 patients (65% women and 35% men), 40-65 years of age, who had a BMI between 25 and 40 kg/m2 and followed a diet with or without oral antidiabetic treatment and 20 controls, blood donors, 15 men (75%) and five women (25%), who had a BMI between 25 and 40 kg/m2 and their age was between 40 and 65 years. Plasmatic levels of oxidative stress markers (tumor necrosis factor-alpha, nitrotyrosine, oxidized low-density lipoprotein) and coagulation markers (factors VII, VIII, IX, XI, XII, antithrombin III and fibrinogen) of both populations were analyzed following statistic criteria. The analyzed data of this study related to oxidative stress and coagulation factors proved that the differences observed between diabetic patients and controls were not statistically significant (P statistically significant (P < 0.01). In patients with DM2, factor VIII increased from 79 to 103%, factor IX from 88 to 103%, factor XII from 87 to 105% and finally, antithrombin III from 81 to 103%. Different results between literature and our study could be due to fact that the patients considered were in the early stage of diabetes when endothelial damage is absent and vascular complications are not clinically expressed. In this study, it is still shown that DM2 is a multifactor disease and its physiopathologic mechanisms are not completely known today.

Colloids removal from water resources using natural coagulant: Acacia auriculiformis

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Abdullah, M.; Roslan, A.; Kamarulzaman, M. F. H.; Erat, M. M.

2017-09-01

All waters, especially surface waters contain dissolved, suspended particles and/or inorganic matter, as well as several biological organisms, such as bacteria, algae or viruses. This material must be removed because it can affect the water quality that can cause turbidity and colour. The objective of this study is to develop water treatment process from Seri Alam (Johor, Malaysia) lake water resources by using natural coagulant Acacia auriculiformis pods through a jar test experiment. Jar test is designed to show the effectiveness of the water treatment. This process is a laboratory procedure that will simulate coagulation/flocculation with several parameters selected namely contact time, coagulant dosage and agitation speed. The most optimum percentage of colloids removal for each parameter is determined at 0.2 g, 90 min and 80 rpm. FESEM (Field-emission Scanning Electron Microscope) observed the small structures of final floc particles for optimum parameter in this study to show that the colloids coagulated the coagulant. All result showed that the Acacia auriculiformis pods can be a very efficient coagulant in removing colloids from water.

Tissue Factor Coagulant Activity is Regulated by the Plasma Membrane Microenvironment.

Science.gov (United States)

Yu, Yuanjie; Böing, Anita N; Hau, Chi M; Hajji, Najat; Ruf, Wolfram; Sturk, Auguste; Nieuwland, Rienk

2018-06-01

 Tissue factor (TF) can be present in a non-coagulant and coagulant form. Whether the coagulant activity is affected by the plasma membrane microenvironment is unexplored.  This article studies the presence and coagulant activity of human TF in plasma membrane micro-domains.  Plasma membranes were isolated from human MIA PaCa2 cells, MDA-MB-231 cells and human vascular smooth muscle cells by Percoll gradient ultracentrifugation after cell disruption. Plasma membranes were fractionated by OptiPrep gradient ultracentrifugation, and the presence of TF, flotillin, caveolin, clathrin, protein disulphide isomerase (PDI), TF pathway inhibitor (TFPI) and phosphatidylserine (PS) were determined.  Plasma membranes contain two detergent-resistant membrane (DRM) compartments differing in density and biochemical composition. High-density DRMs (DRM-H) have a density ( ρ ) of 1.15 to 1.20 g/mL and contain clathrin, whereas low-density DRMs (DRM-L) have a density between 1.09 and 1.13 g/mL and do not contain clathrin. Both DRMs contain TF, flotillin and caveolin. PDI is detectable in DRM-H, TFPI is not detectable in either DMR-H or DRM-L and PS is detectable in DRM-L. The DRM-H-associated TF (> 95% of the TF antigen) lacks detectable coagulant activity, whereas the DRM-L-associated TF triggers coagulation. This coagulant activity is inhibited by lactadherin and thus PS-dependent, but seemed insensitive to 16F16, an inhibitor of PDI.  Non-coagulant and coagulant TF are present within different types of DRMs in the plasma membrane, and the composition of these DRMs may affect the TF coagulant activity. Schattauer GmbH Stuttgart.

Enhanced Coagulation-Flocculation Performance of Iron-Based Coagulants: Effects of PO4(3-) and SiO3(2-) Modifiers.

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Chen, Wei; Zheng, Huaili; Teng, Houkai; Wang, Yili; Zhang, Yuxin; Zhao, Chuanliang; Liao, Yong

2015-01-01

PO4(3-) and SiO3(2-) are often used as modifier to improve stability and aggregating ability of the iron-base coagulants, however, there are few reports about their detailed comparison between the coagulation performance and mechanisms. In this study, three coagulants--polyferric phosphoric sulfate (PFPS), polysilicon ferric sulfate (PFSS), and polyferric sulfate (PFS) were synthesized; their structure and morphology were characterized by Fourier transformed infrared (FT-IR) spectroscopy, X-ray diffraction (XRD) and Scanning electron microscope (SEM). Alkali titration and Ferron species analysis were employed to investigate the hydrolysis performance and species distribution. Jar test was conducted to measure their coagulation behaviors at different dosage, pH, and temperatures in which the flocs properties were measured. The results showed that a number of new compounds were formed due to the presence of PO4(3-) and SiO3(2-). Moreover, PFPS and PFSS had similar level in Fea as well as Feb. Among them, PFPS produced more multi-core iron atoms polymer and content of Feb, and the formed flocs were larger and denser. It exhibited superior coagulation performance in terms of turbidity reduction, UV254 removal and residual ferric concentration. Jar test and floc breakage/regrowth experiments indicated other than charge neutrality, the dominated mechanism involved in PFSS was the adsorption between polysilicic acid and solution particle, while PFPS was sweeping, entrapment/adsorption resulting from larger polymer colloid of Fe-P chemistry bond.

Enhanced Coagulation-Flocculation Performance of Iron-Based Coagulants: Effects of PO4(3- and SiO3(2- Modifiers.

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Wei Chen

Full Text Available PO4(3- and SiO3(2- are often used as modifier to improve stability and aggregating ability of the iron-base coagulants, however, there are few reports about their detailed comparison between the coagulation performance and mechanisms. In this study, three coagulants--polyferric phosphoric sulfate (PFPS, polysilicon ferric sulfate (PFSS, and polyferric sulfate (PFS were synthesized; their structure and morphology were characterized by Fourier transformed infrared (FT-IR spectroscopy, X-ray diffraction (XRD and Scanning electron microscope (SEM. Alkali titration and Ferron species analysis were employed to investigate the hydrolysis performance and species distribution. Jar test was conducted to measure their coagulation behaviors at different dosage, pH, and temperatures in which the flocs properties were measured. The results showed that a number of new compounds were formed due to the presence of PO4(3- and SiO3(2-. Moreover, PFPS and PFSS had similar level in Fea as well as Feb. Among them, PFPS produced more multi-core iron atoms polymer and content of Feb, and the formed flocs were larger and denser. It exhibited superior coagulation performance in terms of turbidity reduction, UV254 removal and residual ferric concentration. Jar test and floc breakage/regrowth experiments indicated other than charge neutrality, the dominated mechanism involved in PFSS was the adsorption between polysilicic acid and solution particle, while PFPS was sweeping, entrapment/adsorption resulting from larger polymer colloid of Fe-P chemistry bond.

Successful Control of Disseminated Intravascular Coagulation by Recombinant Thrombomodulin during Arsenic Trioxide Treatment in Relapsed Patient with Acute Promyelocytic Leukemia

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Motohiro Shindo

2012-01-01

Full Text Available Disseminated intravascular coagulation (DIC frequently occurs in patients with acute promyelocytic leukemia (APL. With the induction of therapy in APL using all-trans retinoic acid (ATRA, DIC can be controlled in most cases as ATRA usually shows immediate improvement of the APL. However, arsenic trioxide (ATO which has been used for the treatment of relapse in APL patients has shown to take time to suppress APL cells, therefore the control of DIC in APL with ATO treatment is a major problem. Recently, the recombinant soluble thrombomodulin fragment has received a lot of attention as the novel drug for the treatment of DIC with high efficacy. Here, we present a relapsed patient with APL in whom DIC was successfully and safely controlled by rTM during treatment with ATO.

Confluent diode laser coagulation: the gold standard of therapy for retinopathy of prematurity.

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Prepiaková, Zuzana; Tomcíková, Dana; Kostolná, Barbora; Gerinec, Anton

2015-01-01

The authors compare results of retinopathy of prematurity treatment with single-spot diode laser coagulation (DLC) versus confluent DLC. The final anatomical outcome and need for additional therapy, such as additional DLC, cryotherapy, scleral buckling, and intravitreal bevacizumab, were evaluated. A retrospective review of patients with threshold retinopathy of prematurity treated between January 2001 and October 2012 was conducted. Single-spot laser treatment or confluent laser treatment was applied anterior to the ridge extending to the ora serrata. In the first group (the single-spot group), a single-spot DLC was used between January 2001 and May 2008. The single-spot group included 338 patients (671 eyes) with retinopathy of prematurity. In the second group (the confluent group), confluent DLC was used in 326 patients (652 eyes) between June 2008 and October 2012. The authors compared the need for re-treatment to achieve regression of retinopathy of prematurity in both groups. The rate of progression, frequency of re-treatment, complications, and structural outcomes were evaluated. In the single-spot group, re-treatment only with DLC was necessary in 43 (6.4%) eyes, additional cryotherapy was performed in 22 (3.3%) eyes, and scleral buckling in 107 (15.9%) eyes. Altogether, additional therapy was used in 172 (25.6%) eyes. In the confluent group, re-treatment with DLC was used in 5 (0.8%) eyes, additional cryotherapy in 6 (0.9%) eyes, scleral buckling in 16 (2.5%) eyes, and intravitreal bevacizumab in 14 (2.1%) eyes. Altogether, additional therapy was used in 41 (6.3%) eyes. The confluent group showed a favorable anatomical outcome in 99.1% of the cases compared with 96.4% in the single-spot group. The results were statistically significant (P = .001.) The DLC method was significantly more effective than single-spot DLC in the treatment of retinopathy of prematurity. Copyright 2015, SLACK Incorporated.

Blood coagulation factor XII drives adaptive immunity during neuroinflammation via CD87-mediated modulation of dendritic cells

Science.gov (United States)

Göbel, Kerstin; Pankratz, Susann; Asaridou, Chloi-Magdalini; Herrmann, Alexander M.; Bittner, Stefan; Merker, Monika; Ruck, Tobias; Glumm, Sarah; Langhauser, Friederike; Kraft, Peter; Krug, Thorsten F.; Breuer, Johanna; Herold, Martin; Gross, Catharina C.; Beckmann, Denise; Korb-Pap, Adelheid; Schuhmann, Michael K.; Kuerten, Stefanie; Mitroulis, Ioannis; Ruppert, Clemens; Nolte, Marc W.; Panousis, Con; Klotz, Luisa; Kehrel, Beate; Korn, Thomas; Langer, Harald F.; Pap, Thomas; Nieswandt, Bernhard; Wiendl, Heinz; Chavakis, Triantafyllos; Kleinschnitz, Christoph; Meuth, Sven G.

2016-01-01

Aberrant immune responses represent the underlying cause of central nervous system (CNS) autoimmunity, including multiple sclerosis (MS). Recent evidence implicated the crosstalk between coagulation and immunity in CNS autoimmunity. Here we identify coagulation factor XII (FXII), the initiator of the intrinsic coagulation cascade and the kallikrein–kinin system, as a specific immune cell modulator. High levels of FXII activity are present in the plasma of MS patients during relapse. Deficiency or pharmacologic blockade of FXII renders mice less susceptible to experimental autoimmune encephalomyelitis (a model of MS) and is accompanied by reduced numbers of interleukin-17A-producing T cells. Immune activation by FXII is mediated by dendritic cells in a CD87-dependent manner and involves alterations in intracellular cyclic AMP formation. Our study demonstrates that a member of the plasmatic coagulation cascade is a key mediator of autoimmunity. FXII inhibition may provide a strategy to combat MS and other immune-related disorders. PMID:27188843

Characterization of coagulation factor synthesis in nine human primary cell types

NARCIS (Netherlands)

Dashty, Monireh; Akbarkhanzadeh, Vishtaseb; Zeebregts, Clark J.; Spek, C. Arnold; Sijbrands, Eric J.; Peppelenbosch, Maikel P.; Rezaee, Farhad

2012-01-01

The coagulation/fibrinolysis system is essential for wound healing after vascular injury. According to the standard paradigm, the synthesis of most coagulation factors is restricted to liver, platelets and endothelium. We challenged this interpretation by measuring coagulation factors in nine human

Clinical review: Thyroid dysfunction and effects on coagulation and fibrinolysis: A systematic review

NARCIS (Netherlands)

Squizzato, A.; Romualdi, E.; Buller, H. R.; Gerdes, V. E. A.

2007-01-01

Context: Various changes in the coagulation-fibrinolytic system have been described in patients with an excess or deficiency of thyroid hormones. The purpose of this systematic review is to summarize the effects of hyperthyroidism and hypothyroidism on these systems. Evidence Acquisition: All

Disseminated intravascular coagulation as an unusual presentation of an Epstein-Barr virus infection

NARCIS (Netherlands)

van Steijn, JHM; van Tol, KM; van Essen, LH; Gans, ROB

2000-01-01

Epstein-Barr viral (EBV)-infection usually presents as fever, sore throat, fatigue, lymphadenopathy and atypical lymphocytosis. We describe a patient with disseminated intravascular coagulation as the presenting symptom caused by a primary EBV infection. (C) 2000 Elsevier Science B.V. All rights

Treatment of sugar beet thick juice spent wash by chemical and natural coagulants

Directory of Open Access Journals (Sweden)

Antov Mirjana G.

2009-01-01

Full Text Available The possibility of treatment of wastewater from bioethanol production by aluminium sulfate and natural coagulant extracted from common bean seed was studied. The highest coagulation activity at pH 6.5 is reached with analum dose of 1 g/l, but only a little lower coagulation activities were obtained by the dose of 0.05 and 0.10 g/l, which is more favorable for economic and environmental reasons. When natural coagulant from common bean was applied the highest coagulation activity, 14.3%, at pH 6.5 is reached with a dose of 0.5 ml/l. However, when common bean natural coagulant was used simultaneously with alum, the highest turbidity removal resulting in 24% coagulation activity was achieved and this was more efficient than when alum or natural coagulant were used.

Elderly trauma patients have high circulating noradrenaline levels but attenuated release of adrenaline, platelets, and leukocytes in response to increasing injury severity

DEFF Research Database (Denmark)

Johansson, Pär I; Sørensen, Anne Marie; Perner, Anders

2012-01-01

: High patient age is a strong predictor of poor outcome in trauma patients. The present study investigated the effect of age on mortality and biomarkers of sympathoadrenal activation, tissue, endothelial, and glycocalyx damage, coagulation activation/inhibition, fibrinolysis, and inflammation in...

PTH treatment activates intracortical bone remodeling in patients with hypoparathyroidism

DEFF Research Database (Denmark)

Sikjær, Tanja Tvistholm; Rejnmark, Lars; Thomsen, Jesper Skovhus

2017-01-01

Hypoparathyroidism (hypoPT) is characterized by a state of low bone turnover and high BMD. We have previously shown that hypoPT patients treated with PTH(1-84) for six months have highly increased bone turnover markers and a decrease in aBMD at the hip and spine(1). The present study aims...... to investigate the effect of PTH(1-84) on cortical bone and intracortical bone remodeling in hypoPT. The study was conducted on 20 transiliac bone biopsies from hypoPT patients after six months of treatment with either PTH(1-84) 100 µg s.c./day N=10 or placebo N=10. The groups were age- (±6 years) and gender...... and diameter were measured. Cortical porosity and pore density did not differ between groups, but PTH treatment had a marked effect on the remodeling status of the pores. The percentage of pores undergoing remodeling was higher in the PTH-group than in placebo-group reported as median values (IQR[25-75%]) (52...

Coagulation defects in experimental hepatic injury in the dog.

Science.gov (United States)

Osbaldiston, G W; Hoffman, M W

1971-04-01

Alteration in activity of blood coagulation factors in dogs with acute hepatic injury caused by oral carbon tetrachloride dosing was studied. Coagulation Factors II, VII and IX were dramatically reduced within 48 hours but recovered to normal in the next five days. Because surgery is rarely performed on dogs with hepatic necrosis, the use of fresh whole blood tranfusion to improve the coagulation defect in hepatic injury was also studied. Transfusion was found to have only a temporary beneficial effect.

Patient preference and ease of use for different coagulation factor VIII reconstitution device scenarios: a cross-sectional survey in five European countries

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Cimino E

2014-12-01

Full Text Available Ernesto Cimino,1 Silvia Linari,2 Mara Malerba,3 Susan Halimeh,4 Francesca Biondo,5 Martina Westfeld5 1Dipartimento Medicina Clinica e Sperimentale, Universita’ degli Studi di Napoli Federico II, Naples, Italy; 2Agenzia per l’ Emofilia, AOU Careggi di Firenze, Florence, Italy; 3Fondazione Cà Granda Ospedale Maggiore Policlinico, Centro Emofilia e Trombosi “A Bianchi Bonomi”, Milan, Italy; 4CRC Coagulation Research Centre GmbH, Duisburg, Germany; 5Pfizer Italia, Rome, Italy Introduction: Hemophilia A treatment involves replacing the deficient coagulation factor VIII. This process may involve multiple steps that might create a barrier to adherence. A new dual-chamber syringe (DCS; FuseNGo® was recently introduced with the aim of simplifying reconstitution. Aim: This study aimed to identify factors associated with adult patients’ preferences for different coagulation factor VIII reconstitution systems and to test ease of use and patient preference for the DCS. Methods: A cross-sectional survey of adults with hemophilia A in five European countries was conducted; a subset of subjects also participated in a practical testing session of the DCS. Results: Among the 299 survey participants, the device scenario requiring the least equipment and reconstitution steps (the DCS received a median preference rating of 71 out of 100 (0 being “the least desirable” and 100 “the most desirable” rating. This was significantly higher than the other scenarios (the next highest achieved a median of 50 points; P<0.001. Participants would be more likely to use this device prophylactically (P<0.001. Among the 98 participants who tested the DCS, 57% preferred this device over their current device, 26% preferred their current device, and 17% had no preference. The DCS was rated as easier to use than current treatment devices (median score 9/10 versus 7/10 for current treatment, P=0.001. Conclusion: The survey indicates that the prefilled DCS, Fuse

Treatment of phosphate-containing oily wastewater by coagulation and microfiltration.

Science.gov (United States)

Zhang, Jin; Sun, Yu-xin; Huang, Zhi-feng; Liu, Xing-qin; Meng, Guang-yao

2006-01-01

The oily wastewater generated from pretreatment unit of electrocoating industry contains oils, phosphate, organic solvents, and surfactants. In order to improve the removal efficiencies of phosphate and oils, to mitigate the membrane fouling, coagulation for ceramic membrane microfiltration of oily wastewater was performed. The results of filtration tests show that the membrane fouling decreased and the permeate flux and quality increased with coagulation as pretreatment. At the coagulant Ca (OH)2 dosage of 900 mg/L, the removal efficiency of phosphate was increased from 46.4% without coagulation to 99.6%; the removal of COD and oils were 97.0% and 99.8%, respectively. And the permeate flux was about 70% greater than that when Ca(OH)2 was not used. The permeate obtained from coagulation and microfiltration can be reused as make-up water, and the recommended operation conditions for pilot and industrial application are transmembrane pressure of 0.10 MPa and cross-flow velocity of 5 m/s. The comparison results show that 0.2 microm ZrO2 microfilter with coagulation could be used to perform the filtration rather than conventional ultrafilter, with very substantial gain in flux and removal efficiency of phosphate.

IMPROVEMENT OF COAGULATION PROCESS FOR THE PRUT RIVER WATER TREATMENT USING ALUMINUM SULPHATE

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Larisa Postolachi

2015-06-01

Full Text Available The aim of presented research was to optimize the treatment process of the Prut River water. In order to realize the proposed goal, there were studied the following factors which can improve the process of coagulation: (i the influence of stirring speed during coagulation and (ii the influence of the concentration of the coagulant solution added in the process of coagulation. The optimal conditions of coagulation were established using the Jar-test method. Application of the recommended procedure contribute to the reduction of the coagulant dose, the contact time, the aluminum concentration in water and the expenses for water treatment.

hypoDD-A Program to Compute Double-Difference Hypocenter Locations

Science.gov (United States)

Waldhauser, Felix

2001-01-01

HypoDD is a Fortran computer program package for relocating earthquakes with the double-difference algorithm of Waldhauser and Ellsworth (2000). This document provides a brief introduction into how to run and use the programs ph2dt and hypoDD to compute double-difference (DD) hypocenter locations. It gives a short overview of the DD technique, discusses the data preprocessing using ph2dt, and leads through the earthquake relocation process using hypoDD. The appendices include the reference manuals for the two programs and a short description of auxiliary programs and example data. Some minor subroutines are presently in the c language, and future releases will be in c. Earthquake location algorithms are usually based on some form of Geiger’s method, the linearization of the travel time equation in a first order Taylor series that relates the difference between the observed and predicted travel time to unknown adjustments in the hypocentral coordinates through the partial derivatives of travel time with respect to the unknowns. Earthquakes can be located individually with this algorithm, or jointly when other unknowns link together the solutions to indivdual earthquakes, such as station corrections in the joint hypocenter determination (JHD) method, or the earth model in seismic tomography. The DD technique (described in detail in Waldhauser and Ellsworth, 2000) takes advantage of the fact that if the hypocentral separation between two earthquakes is small compared to the event-station distance and the scale length of velocity heterogeneity, then the ray paths between the source region and a common station are similar along almost the entire ray path (Fréchet, 1985; Got et al., 1994). In this case, the difference in travel times for two events observed at one station can be attributed to the spatial offset between the events with high accuracy. DD equations are built by differencing Geiger’s equation for earthquake location. In this way, the residual between

Disseminated intravascular coagulation (DIC)

Science.gov (United States)

... Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice . 6th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 141. Thachil J, Toh CH. Current concepts in the management of disseminated intravascular coagulation. Thromb Res . 2012;129 ...

Benign intracranial hypertension associated to blood coagulation derangements

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Niglio Alferio

2006-12-01

Full Text Available Abstract Background Benign Intracranial Hypertension (BIH may be caused, at least in part, by intracranial sinus thrombosis. Thrombosis is normally due to derangements in blood coagulation cascade which may predispose to abnormal clotting activation or deficiency in natural inhibitors' control. The aim of the study is to examine the strength of the association between risk factors for thrombosis and BIH. Patients and methods The incidence of prothrombotic abnormalities among a randomly investigated cohort of 17 patients with BIH, was compared with 51 healthy subjects matched for sex, age, body mass index, height and social background. Results The number of subjects with protein C deficiency was significantly higher in patients than in controls (3 vs 1, p Increased plasma levels of prothrombin fragment 1+2, fibrinopeptide A (FPA, and PAI-1 were demonstrated in patients group (5.7 ± 1.15 nM vs 0.45 ± 0.35 nM; 8.7 ± 2.5 ng/mL vs 2.2 ± 1.25 ng/mL; 45.7 ± 12.5 ng/mL vs 8.5 ± 6.7 ng/mL, respectively; p Discussion In agreement with other authors our data suggest a state of hypercoagulability in BIH associated with gene polymorphisms. Our findings also showed that mutations in cardiovascular genes significantly discriminate subjects with a BIH history. The association between coagulation and gene derangements, usually regarded to as cryptogenic, may suggest a possible pathogenetic mechanism in BIH. So, a prothrombotic tendency may exist that would, at least in part, explain some cases of BIH. Although based on a small population, these findings raise the exciting possibility of using these haemostatic factors as markers for selecting high-risk subjects in BIH disease.

Vitamin K: from coagulation to calcification.

Science.gov (United States)

Paakkari, Ilari

Vitamin K is not only essential for the synthesis of coagulation factors in the liver, but it also strengthens the bones and prevents calcification of the arteries. These effects are mediated through the same mechanism, i.e. carboxylation of Gla target proteins. The discovery of novel Gla proteins that are not associated with blood coagulation or calcium metabolism indicates that vitamin K has additional effects in the pancreas and the central nervous system, for example. As dietary supplements, vitamin K1 of plant origin and vitamins K2 of bacterial origin may exert different effects.

WATER PURIFICATION BY COAGULATION UNDER THE INFLUENCE OF ULTRASONIC FIELD

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Vikulina Vera Borisovna

2016-03-01

Full Text Available The authors carried out experiments on the in-fluence of ultrasound on the subsidence of suspended materials. The efficiency of coagulation process in wa-ter purification in ultrasound field is estimated. The influence of ultrasound on the water with suspended materials before introducing coagulant was a condition of the experiment. The magnetostriction method for obtaining ultrasound oscillations with the help of ultra-sound generator of batch production was applied. The samples were chosen and the coagulation process was controlled using standard procedures. The experimental data was obtained which estimate the efficiency in-crease in the subsidence of suspended materials de-pending on the duration of ultrasound processing. Dur-ing one minute of ultrasound processing the following results were obtained: the subsidence efficiency in-creased by 25.83 % in case of coagulant share Al2O3 2.5 mg/l; the subsidence efficiency increased by 23.70 % in case of coagulant share Al2O3 5.0 mg/l.

Acute Kidney Injury due to Menstruation-related Disseminated Intravascular Coagulation in an Adenomyosis Patient: A Case Report

Science.gov (United States)

Son, Jungmin; Seong, Eun Young; Song, Sang Heon; Lee, Soo Bong; Kang, Jin; Yang, Byeong Yun; Lee, Su Jin; Choi, Jong-Ryeol; Lee, Kyu-Sup; Kwak, Ihm Soo

2010-01-01

The authors report a case of acute kidney injury (AKI) resulting from menstruation-related disseminated intravascular coagulation (DIC) in an adenomyosis patient. A 40-yr-old woman who had received gonadotropin for ovulation induction therapy presented with anuria and an elevated serum creatinine level. Her medical history showed primary infertility with diffuse adenomyosis. On admission, her pregnancy test was negative and her menstrual cycle had started 1 day previously. Laboratory data were consistent with DIC, and it was believed to be related to myometrial injury resulting from heavy intramyometrial menstrual flow. Gonadotropin is considered to play an important role in the development of fulminant DIC. This rare case suggests that physicians should be aware that gonadotropin may provoke fulminant DIC in women with adenomyosis. PMID:20808684

Coagulation and flocculation of dissolved organic substances with organic polymers

OpenAIRE

Kvinnesland, Thomas

2002-01-01

Coagulation of natural organic matter (NOM) in water is a well-established process, enabling or enhancing the removal of these substances by different particle separation processes. The dominating coagulating agents used are, however, inorganic salts of iron (Fe3+) and aluminium (Al3+). The primary use of organic polymers is as flocculating agents for already coagulated aggregates. However, in recent years the use of cationic organic polymers have received increasing attent...

Does inter-vertebral range of motion increase after spinal manipulation? A prospective cohort study.

Science.gov (United States)

Branney, Jonathan; Breen, Alan C

2014-01-01

Spinal manipulation for nonspecific neck pain is thought to work in part by improving inter-vertebral range of motion (IV-RoM), but it is difficult to measure this or determine whether it is related to clinical outcomes. This study undertook to determine whether cervical spine flexion and extension IV-RoM increases after a course of spinal manipulation, to explore relationships between any IV-RoM increases and clinical outcomes and to compare palpation with objective measurement in the detection of hypo-mobile segments. Thirty patients with nonspecific neck pain and 30 healthy controls matched for age and gender received quantitative fluoroscopy (QF) screenings to measure flexion and extension IV-RoM (C1-C6) at baseline and 4-week follow-up between September 2012-13. Patients received up to 12 neck manipulations and completed NRS, NDI and Euroqol 5D-5L at baseline, plus PGIC and satisfaction questionnaires at follow-up. IV-RoM accuracy, repeatability and hypo-mobility cut-offs were determined. Minimal detectable changes (MDC) over 4 weeks were calculated from controls. Patients and control IV-RoMs were compared at baseline as well as changes in patients over 4 weeks. Correlations between outcomes and the number of manipulations received and the agreement (Kappa) between palpated and QF-detected of hypo-mobile segments were calculated. QF had high accuracy (worst RMS error 0.5o) and repeatability (highest SEM 1.1o, lowest ICC 0.90) for IV-RoM measurement. Hypo-mobility cut offs ranged from 0.8o to 3.5o. No outcome was significantly correlated with increased IV-RoM above MDC and there was no significant difference between the number of hypo-mobile segments in patients and controls at baseline or significant increases in IV-RoMs in patients. However, there was a modest and significant correlation between the number of manipulations received and the number of levels and directions whose IV-RoM increased beyond MDC (Rho=0.39, p=0.043). There was also no agreement

The performance of double layer structure membrane prepared from flowing coagulant

Science.gov (United States)

Mieow Kee, Chan; Xeng, Anthony Leong Chan; Regal, Sasiskala; Singh, Balvinder; Raoo, Preeshaath; Koon Eu, Yap; Sok Choo, Ng

2017-12-01

Membrane with double layer structure is favourable as it exhibits smooth surface and macrovoids free structure. However, its’ performance in terms of permeability, porosity and strength has not been studied thoroughly. Additionally, the effect of flowing coagulant on the formation of double layer membrane has not been reported. Thus, the objective of this study is to investigate the performance of double layer membranes, which were prepared using flowing coagulant. Results showed that when the coagulant flow changed from laminar to turbulent, the pure water permeation of the membrane increased. It was due to the higher porosity in the membrane, which prepared by turbulent flow (CA-Turbulent) compared to the membrane which fabricated under laminar condition (CA-Laminar). This can be explained by the rapid solvent-coagulant exchange rate between the polymer solution and the turbulent coagulant. In term of strength, the tensile strength of the CA-Turbulent was ~32 MPa, which was 100% higher compared to CA-Laminar. This may due to the presence of large amount of nodules on its surface, which reduced the surface integrity. In conclusion, flowing coagulant altered the membrane properties and adopting turbulent coagulant flow in membrane fabrication would improve the porosity, surface roughness and the strength of the membrane.

Patient-centred outcomes research: perspectives of patient stakeholders.

Science.gov (United States)

Chhatre, Sumedha; Gallo, Joseph J; Wittink, Marsha; Schwartz, J Sanford; Jayadevappa, Ravishankar

2017-11-01

To elicit patient stakeholders' experience and perspectives about patient-centred care. Qualitative. A large urban healthcare system. Four patient stakeholders who are prostate cancer survivors. Experience and perspectives of patient stakeholders regarding patient-centred care and treatment decisions. Our patient stakeholders represented a diverse socio-demographic group. The patient stakeholders identified engagement and dialogue with physicians as crucial elements of patient-centred care model. The degree of patient-centred care was observed to be dependent on the situations. High severity conditions warranted a higher level of patient involvement, compared to mild conditions. They agreed that patient-centred care should not mean that patients can demand inappropriate treatments. An important attribute of patient-centred outcomes research model is the involvement of stakeholders. However, we have limited knowledge about the experience of patient stakeholders in patient-centred outcomes research. Our study indicates that patient stakeholders offer a unique perspective as researchers and policy-makers aim to precisely define patient-centred research and care.

Coagulation and Adsorption Treatment of Printing Ink Wastewater

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Maja Klančnik

2015-03-01

Full Text Available The intention of the study was to improve the efficiency of total organic carbon (TOC and colour removal from the wastewater samples polluted with flexographic printing ink following coagulation treatments with further adsorption onto activated carbons and ground orange peel. The treatment efficiencies were compared to those of further flocculation treatments and of coagulation and adsorption processes individually. Coagulation was a relatively effective single-treatment method, removing 99.7% of the colour and 86.9% of the organic substances (TOC from the printing ink wastewater samples. Further flocculation did not further eliminate organic pollutants, whereas subsequent adsorption with 7 g/l of granular activated carbon further reduced organic substances by 35.1%, and adsorption with 7 g/l of powdered activated carbon further reduced organic substances by 59.3%. Orange peel was an inappropriate adsorbent for wastewater samples with low amounts of pollution, such as water that had been treated by coagulation. However, in highly polluted printing ink wastewater samples, the adsorption treatment with ground orange peel achieved efficiencies comparable to those of the granular activated carbon treatments.

Novel approaches to the management of disseminated intravascular coagulation

NARCIS (Netherlands)

Levi, M. [=Marcel M.; de Jonge, E.; van der Poll, T.; ten Cate, H.

2000-01-01

Disseminated intravascular coagulation (DIC) is a syndrome characterized by systemic intravascular activation of coagulation, leading to widespread deposition of fibrin in the circulation. We addressed the issue of whether there is evidence that this fibrin deposition contributes to multiple organ

A Pontential Agriculture Waste Material as Coagulant Aid: Cassava Peel

Science.gov (United States)

Othman, N.; Abd-Rahim, N.-S.; Tuan-Besar, S.-N.-F.; Mohd-Asharuddin, S.; Kumar, V.

2018-02-01

All A large amount of cassava peel waste is generated annually by small and medium scale industries. This has led to a new policy of complete utilization of raw materials so that there will be little or no residue left that could pose pollution problems. Conversion of these by-products into a material that poses an ability to remove toxic pollutant would increase the market value and ultimately benefits the producers. This study investigated the characteristics of cassava peel as a coagulant aid material and optimization process using the cassava peel was explored through coagulation and flocculation. This research had highlighted that the Cassava peels contain sugars in the form of polysaccharides such as starch and holocellulose. The FTIR results revealed that amino acids containing abundant of carboxyl, hydroxyl and amino groups which has significant capabilities in removing pollutants. Whereas analysis by XRF spectrometry indicated that the CP samples contain Fe2O3 and Al2O3 which might contribute to its coagulation ability. The optimum condition allowed Cassava peel and alum removed high turbidity up to 90. This natural coagulant from cassava peel is found to be an alternative coagulant aid to reduce the usage of chemical coagulants

Evaluation of Impact of Coagulant Type on Operation Parameters in Direct Filtration

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Ali Torabian

2007-06-01

Full Text Available Numerous advantages have been reported on PAC (poly aluminum chloride used as a coagulant over other coagulants such as alum and ferric chloride used in conventional water treatment process with medium and high turbidity levels. These include lower amounts of PACL required specially in removing turbidity, larger floc grain formation, reduced floc sedimentation time, lower sludge production, and relaxation of the need for pH adjustment by lime, among others. The present study aims to evaluate the effects of different coagulants such as ferric chloride and PACL on direct filtration and to identify the most effective material based on both turbidity and particle removal efficiencies. A perfectly experimental pilot system, including raw water preparation, coagulation, flocculation, distribution measurement, and filtration units, was designed and used. Raw water turbidity level in the experimental pilot was below 10 NTU. The effects of various parameters such as coagulant type, filtration rate, and coagulant dosage on the performance of the filter were investigated. The results obtained from several filtration cycles under different conditions indicated that average effluent turbidity level, effluent particle numbers, effluent turbidity variation graph, and effluent particle graph were lower throughout the filtration cycle when PACL was used compared to when ferric chloride was used as the coagulant. Increasing filtration rate led to increased turbidity and particle number. Addition of 2 mg/l of PACL (poor coagulation and flocculation scenario was compared with addition of 5 mg/l of ferric chloride (strong coagulation and flocculation scenario. The results indicated that higher average values of turbidity removal but lower turbidity and particle removal efficiencies obtained in the case of the poor coagulation and flocculation scenario.

Is argon plasma coagulation an effective and safe treatment option for patients with chronic radiation proctitis after high doses of radiotherapy?

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Eduardo Hortelano

Full Text Available Introduction: In severe cases refractory to medical treatment, APC appears to be the preferred alternative to control persistent rectal bleeding of patients with chronic radiation proctitis. Although successful outcomes have been demonstrated in patients previously treated with moderate doses of radiotherapy, there is reluctance towards its indication due to the concern of severe adverse events in patients treated with high doses of radiation. Objectives: The aim of this study was to assess the efficacy and toxicity of APC in the management of bleeding radiation-induced proctitis in patients treated with high doses of radiation for prostate cancer. Methods and materials: Data from 30 patients were treated with APC due to chronic radiation proctitis, were reviewed retrospectively. All cases had prostate cancer and 9 of them (30 % underwent previous radical prostatectomy. The median dose of conformal 3D External Beam Radiotherapy (EBRT delivered was 74 Gy (range 46-76. Median rectal D1cc and D2cc was 72.5 and 72.4 Gy respectively. Median rectal V70, V60 and V40 was 12, 39.5 and 80 %. Cardiovascular and digestive disease, diabetes, smoking behaviour, lowest haemoglobin and transfusion requirements were recorded. Indications for treatment with APC were anemia and persistent bleeding despite medical treatment. Argon gas flow was set at 1.8 l/min with an electrical power setting of 50 W. Results: Median age of all patients was 69.6 years. The median lowest haemoglobin level was 9.6 g/dL. Median time between completion of radiotherapy and first session of APC was 13 months. Ninety-four therapeutic sessions were performed (median 3 sessions. Median time follow-up was 14.5 months (range 2-61. Complete response with resolved rectal bleeding was achieved in 23 patients (77 %, partial response in 5 (16 % and no control in 2 (6 %. No patients required transfusion following therapy. Two patients developed long-term (> 6 weeks grade 2 rectal ulceration and

Treatment of sugar beet extraction juice stillage by natural coagulants extracted from common bean

Directory of Open Access Journals (Sweden)

Prodanović Jelena M.

2015-01-01

Full Text Available Distillery wastewaters have a great pollution potential, and pollution caused by them is one of the most critical environmental issues. This study is concerned with the coagulation efficiency of a new, environmental friendly, natural coagulant extracted from common bean seeds in the primary treatment of distillery wastewater in the bioethanol production from sugar beet juice. Active coagulation components were extracted from ground seeds of common bean with 0.5 mol/L NaCl. The obtained raw extract was used as a coagulant. The coagulation efficiency was measured by jar test at different pH values of wastewater, and a decrease in organic matter content was determined. The experiments confirmed that natural coagulant from common bean could be successfully used for the treatment of extraction juice distillery wastewater. The highest coagulation efficiencies were achieved at the pH 5.2 with a coagulant dose of 30 mL/L, and at the pH 8.5 with a coagulant dose of 5 mL/L, and they were 64.71% and 68.75% respectively. These encouraging results indicate that natural coagulant from common bean seeds is a potential alternative to conventional chemical coagulant/flocculant agents for treatment of wastewaters.[Projekat Ministarstva nauke Republike Srbije, br. III 43005

On the boundary behavior of left-invariant Hitchin and hypo flows

DEFF Research Database (Denmark)

Belgun, Florin; Cortés, Vicente; Freibert, Marco

2015-01-01

We investigate left-invariant Hitchin and hypo flows on 5-, 6- and 7-dimensional Lie groups. They provide Riemannian cohomogeneity-one manifolds of one dimension higher with holonomy contained in SU(3), G2 and Spin(7), respectively, which are in general geodesically incomplete. Generalizing results...... of Conti, we prove that for large classes of solvable Lie groups G these manifolds cannot be completed: a complete Riemannian manifold with parallel SU(3)-, G2- or Spin(7)-structure which is of cohomogeneity one with respect to G is flat, and has no singular orbits. We furthermore classify, on the non...

Comparison of argon plasma coagulation in management of upper gastrointestinal angiodysplasia and gastric antral vascular ectasia hemorrhage.

Science.gov (United States)

Chiu, Yi-Chun; Lu, Lung-Sheng; Wu, Keng-Liang; Tam, William; Hu, Ming-Luen; Tai, Wei-Chen; Chiu, King-Wah; Chuah, Seng-Kee

2012-06-09

Vascular ectasias, including gastric antral vascular ectasia (GAVE) and angiodysplasia, are increasingly recognized as important sources of gastrointestinal bleeding. This study investigated and compared the efficacies and outcomes of treatment of upper gastrointestinal (UGI) angiodysplasia and GAVE hemorrhage by endoscopic argon plasma coagulation (APC). From January 2006 to December 2009, 46 patients diagnosed with upper GI bleeding caused by angiodysplasia or GAVE at a tertiary hospital were recruited into this study. They included 26 males and 20 females with an average age of 65.6 years (range, 45-90 years). All patients underwent APC for hemostasis during an endoscopic procedure. Parameters such as underlying co-morbidities, number of endoscopic treatment sessions, recurrent bleeding, and clinical outcomes during follow-up were analyzed. The 46 patients with UGI vascular ectasia hemorrhage included 27 patients with angiodysplasia and 19 with GAVE. The patients with angiodysplasia were older than those with GAVE (71.6 ± 10.2 years versus 61.8 ± 11.9 years, P = 0.005). More GAVE patients than angiodysplasia patients had co-existing liver cirrhosis (63.2% versus 25.9%, P = 0.012). The patients with GAVE had a higher rate of recurrent bleeding (78.9% versus 7.4%, P bleeding. Further multivariate analysis revealed that GAVE was the only independent risk factor for recurrent bleeding after APC treatment (OR = 0.027, P bleeding. The efficacy of APC treatment is greater for angiodysplasia than for vascular ectasia bleeding. GAVE patients have a higher recurrent bleeding rate and may require multiple treatment sessions for sustained hemostasis.

High plasma homocyst(e)ine levels in elderly Japanese patients are associated with increased cardiovascular disease risk independently from markers of coagulation activation and endothelial cell damage.

Science.gov (United States)

Kario, K; Duell, P B; Matsuo, T; Sakata, T; Kato, H; Shimada, K; Miyata, T

2001-08-01

Elevated plasma homocyst(e)ine is a risk factor for cardiovascular disease (CVD) in many populations, but the relationship between homocyst(e)ine and CVD in Japanese subjects has been unclear. It has been hypothesized that the link between homocyst(e)ine and CVD may be mediated in part by activation of coagulation and endothelial cell injury in the elderly Japanese subjects. To further evaluate this hypothesis, the present cross-sectional study was designed to assess the relationships among plasma homocyst(e)ine concentrations, risk of CVD, and markers of coagulation (fibrinogen, FVII, F1+2, FVIIa and FXIIa) and endothelial cell damage (vWF and thrombomodulin) in 146 elderly Japanese subjects (79 healthy controls and 67 patients with CVD). The geometric mean (range) of plasma homocyst(e)ine concentrations was 10.2 (3.2--33) micromol/l in 79 Japanese healthy elderly subjects. As expected, healthy female and male elderly subjects had homocyst(e)ine levels that were 2.5 and 5.3 micromol/; higher, respectively, compared to healthy young control subjects (n=62). Healthy young and elderly men had homocyst(e)ine levels that were 1.7 and 4.5 micromol/l higher, respectively, compared to values in women. This higher plasma homocyst(e)ine levels in the elderly subjects were negatively correlated with levels of folic acid, albumin and total cholesterol, but were not significantly related to markers of coagulation or endothelial cell-damage. The results of multiple logistic regression analyses suggested that high homocyst(e)ine levels were independently related to CVD risk. In addition, levels of FVIIa, and F1+2 were significantly higher in elderly Japanese patients with CVD compared to elderly subjects without CVD, but were unrelated to plasma homocyst(e)ine concentrations. In summary, elevated plasma concentrations of homocyst(e)ine, FVIIa, and F1+2 were associated with increased risk of CVD in elderly male and female Japanese subjects, but the association between homocyst

Operating Conditions of Coagulation-Flocculation Process for High Turbidity Ceramic Wastewater

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Sameer Al-Asheh

2017-04-01

Full Text Available This work attempted to determine the optimum conditions required for the coagulation and flocculation process as an essential stage of the ceramic wastewater treatment. Coagulation and flocculation is a very necessary step in industries as it lessens turbidity, color, and odor of wastewater. The experimental work was performed in several runs. The volume of wastewater used in each run was 200 mL and was kept at this value throughout. In certain runs, the speed of the mixer was varied while keeping the quantity of coagulant and flocculant constant in order to determine the optimum speed that resulted in the least turbidity. A speed of 5% was chosen as the ideal process speed according to the results obtained. Next, experiments were operated at this optimum speed while changing the dosage of coagulant and flocculant in order to decide the optimum dosage. Coagulant and flocculent amounts of 0.4 g (without booster and 0.2 g (with booster selected after the readings were taken. For all the readings, a turbidity meter was used providing results in Nephelometric Turbidity Units (NTU. Lowest turbidity was achieved when using 5% speed with 0.4 grams of coagulant and 0.4 grams of flocculant, or 5% speed with 0.2 grams of coagulant, 0.2 grams of flocculant and 0.25 g/L of booster coagulant. According to factorial design analysis, such as parameters as impeller speed and dosage have an influential impact on the turbidity; while the booster has insignificant influence and other interactions between parameters are important.

Treatment of sugar beet thick juice spent wash by chemical and natural coagulants

OpenAIRE

Antov Mirjana G.; Klašnja Mile T.; Šćiban Marina B.

2009-01-01

The possibility of treatment of wastewater from bioethanol production by aluminium sulfate and natural coagulant extracted from common bean seed was studied. The highest coagulation activity at pH 6.5 is reached with analum dose of 1 g/l, but only a little lower coagulation activities were obtained by the dose of 0.05 and 0.10 g/l, which is more favorable for economic and environmental reasons. When natural coagulant from common bean was applied the highest coagulation activity, 14.3%, at pH ...

Coagulation sensors based on magnetostrictive delay lines for biomedical and chemical engineering applications

International Nuclear Information System (INIS)

Maliaritsi, E.; Zoumpoulakis, L.; Simitzis, J.; Vassiliou, P.; Hristoforou, E.

2006-01-01

Coagulation sensors based on the magnetostrictive delay line technique are presented in this paper. They are based on magnetostrictive ribbons and are used for measuring the coagulation, curing or solidification time of different liquids. Experimental results indicate that the presented sensing elements can determine the blood coagulation with remarkable repeatability, thus allowing their use as blood coagulation sensors. Additionally, results indicate that they can also measure curing time of resins, solidification of fluids and coagulation of chemical substances, therefore allowing their implementation in chemical engineering applications

Superiority of ferric chloride as coagulant over alum and ferrous sulphate at controlled pH and cost comparison of these coagulant

International Nuclear Information System (INIS)

Irfan, M.

2008-01-01

This study was conducted by author as a member of Specialty Chemical Division of Sitara Chemical Industries which is the largest chlor -alkali manufacturing industry in Pakistan. Sitara is also producing FeCl/sub 3/ as a byproduct to consume its additional quantity of chlorine produced during electrolysis of brine solution for caustic soda preparation. Most of the industries are using Alum along with other polymers for treatment of effluent waste water. Treatment system is based on sand bed filters. For coagulation of unwanted materials present in the water, Alum is being used with Anionic Polymer (Accofloc-A2125) as flocculent. But the ferric chloride is not only functions as a reactants to remove water impurities but it also functions as a both coagulant and a Flocculent. This study was conducted for finding best alternative chemicals to improve treated water quality. For this purpose Ferric Chloride (FeCl/sub 3/) is used as best alternative of alum for better removal of turbidity, heavy metals and micro organisms to eradicate above said problems and for better removal of turbidity, heavy metals and micro, organisms to eradicate health problems. As per lab scale results quality of treated water with Ferric Chloride (FeCl/sub 3/) proved better than that of Alum. The main objective of this research is to investigate the efficiency of coagulation and flocculation processes for removing suspended solids, colour and COD which present in significant quantity. Three types of coagulants were examined using standard jar test apparatus, i.e., aluminum sulphate (alum), ferric chloride (FeCl/sub 3/) and ferrous sulphate (FeSO/sub 4/). The effects of agitation speed, settling time, pH, coagulant dosages and temperature were examined. At 300 rpm of rapid mixing and 50 rpm of slow mixing and 60 minutes settling time, higher removals of suspended solids (over 95%), colour (90%) and COD (43%) were achieved at pH 4 and 12. FeCl/sub 3/ was found to be superior compared with other

Using Coagulation Process in Optimizing Natural Organic Matter Removal from Low Turbidity Waters

Directory of Open Access Journals (Sweden)

Alireza Mesdaghinia

2006-03-01

Full Text Available Optimization of coagulation process  for efficient removal of Natural Organic Matters (NOM has gained a lot of focus over the last years to meet the requirements of enhanced coagulation. NOM comprises both particulate and soluble components which the latter usually comprises the main portion. Removal of soluble NOM from low turbidity waters by coagulation is not a successful process unless enough attention is paid to stages of formation and development of both micro and macro-flocs. This study, which presents experimental results from pilot scale research studies aimed at optimizing coagulation process applied to synthetic raw waters supplemented by adding commercial humic acid with low turbidity levels, explains how pH and turbidity can be controlled to maximize soluble NOM removal. The removal of NOM at various coagulant doses and coagulation pHs has been assessed through raw and treated (coagulated-settled water measurements of total organic carbon (TOC. For low turbidity waters, essential floc nucleation sites can be provided by creating synthetic turbidities, for example by adding clay. Adjusting the initial pH at 5.5 or adding clay before coagulant addition allows the formation of micro-flocs as well as formation of the insoluble flocs at low coagulant doses.

EVALUATION OF PERIODONTAL TISSUES CONDITION IN CHILDREN WITH BLOOD COAGULABILITY PATHOLOGY

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M. A. Gavrilenko

2013-12-01

Full Text Available Background. Actuality of the problem is determined by the high prevalence of inflammatory diseases of periodontal tissues in children with blood pathology (100%. Primary prevention of dental caries and periodontal diseases has the exceptional importance in the dentist’s work with children who have blood coagulability disorders. Prevention of dental diseases of the oral cavity in this category of patients has a number of features because there is the risk of bleeding during both home oral hygiene and professional hygiene. Exogenous prevention (fluoride-containing gels, varnishes, solutions, sealants also has its own peculiarities in these children. On the other hand, the impossibility of preventive measures implementation is the significant factor in the pathogenesis of gingivitis and subsequently periodontitis in children with disorders of blood coagulability. Aim. To examine the status of oral hygiene in children with blood coagulability disorders. To examine the severity of inflammatory and destructive changes in the periodontal tissues in children with disorders of blood coagulability. To investigate timing and frequency of oral hygiene implementation in children with disorders of blood coagulability. To reveal the interrelations between the intensity, prevalence of periodontal tissues disorders in children with blood coagulability pathology and the periods of tooth development, taking into account the influence of risk factors and frequency of oral hygiene. Materials and methods. 120 children between 2 and 18 years old with blood coagulability disorders (hemophilia A, B, thrombocytopenia, thrombocytopathy were examined. Children were divided into following age groups: I – 2-5 years old (40 children, II – 6-10 years old (40 children, III – 11-18 years old (40 children, according to the periods of tooth development, with an equal number of children in groups according to diagnoses. Hygiene index value was determined according to

Evaluation of periodontal tissues condition in children with blood coagulability pathology

Directory of Open Access Journals (Sweden)

M. A. Gavrilenko

2013-12-01

Full Text Available Background. Actuality of the problem is determined by the high prevalence of inflammatory diseases of periodontal tissues in children with blood pathology (100%. Primary prevention of dental caries and periodontal diseases has the exceptional importance in the dentist’s work with children who have blood coagulability disorders. Prevention of dental diseases of the oral cavity in this category of patients has a number of features because there is the risk of bleeding during both home oral hygiene and professional hygiene. Exogenous prevention (fluoride-containing gels, varnishes, solutions, sealants also has its own peculiarities in these children. On the other hand, the impossibility of preventive measures implementation is the significant factor in the pathogenesis of gingivitis and subsequently periodontitis in children with disorders of blood coagulability. Aim.To examine the status of oral hygiene in children with blood coagulability disorders.To examine the severity of inflammatory and destructive changes in the periodontal tissues in children with disorders of blood coagulability. To investigate timing and frequency of oral hygiene implementation in children with disorders of blood coagulability. To reveal the interrelations between the intensity, prevalence of periodontal tissues disorders in children with blood coagulability pathology and the periods of tooth development, taking into account the influence of risk factors and frequency of oral hygiene. Materials and methods. 120 children between 2 and 18 years old with blood coagulability disorders (hemophilia A, B, thrombocytopenia, thrombocytopathy were examined. Children were divided into following age groups: I – 2-5 years old (40 children, II – 6-10 years old (40 children, III – 11-18 years old (40 children, according to the periods of tooth development, with an equal number of children in groups according to diagnoses. Hygiene index value was determined according to Fedorov

Charging and coagulation of radioactive and nonradioactive particles in the atmosphere

International Nuclear Information System (INIS)

Kim, Yong-ha; Yiacoumi, Sotira

2016-01-01

Charging and coagulation influence one another and impact the particle charge and size distributions in the atmosphere. However, few investigations to date have focused on the coagulation kinetics of atmospheric particles accumulating charge. This study presents three approaches to include mutual effects of charging and coagulation on the microphysical evolution of atmospheric particles such as radioactive particles. The first approach employs ion balance, charge balance, and a bivariate population balance model (PBM) to comprehensively calculate both charge accumulation and coagulation rates of particles. The second approach involves a much simpler description of charging, and uses a monovariate PBM and subsequent effects of charge on particle coagulation. The third approach is further simplified assuming that particles instantaneously reach their steady-state charge distributions. It is found that compared to the other two approaches, the first approach can accurately predict time-dependent changes in the size and charge distributions of particles over a wide size range covering from the free molecule to continuum regimes. The other two approaches can reliably predict both charge accumulation and coagulation rates for particles larger than about 0.04 micrometers and atmospherically relevant conditions. These approaches are applied to investigate coagulation kinetics of particles accumulating charge in a radioactive neutralizer, the urban atmosphere, and an atmospheric system containing radioactive particles. Limitations of the approaches are discussed.

Simultaneous lactic acidification and coagulation by using recombinant Lactococcus lactis strain.

Science.gov (United States)

Raftari, M; Ghafourian, S; Abu Bakar, F

2017-04-01

This study was an attempt to create a novel milk clotting procedure using a recombinant bacterium capable of milk coagulation. The Rhizomucor pusillus proteinase (RPP) gene was sub-cloned into a pALF expression vector. The recombinant pALF-RPP vector was then electro-transferred into Lactococcus lactis. Finally, the milk coagulation ability of recombinant L. lactis carrying a RPP gene was evaluated. Nucleotide sequencing of DNA insertion from the clone revealed that the RPP activity corresponded to an open reading frame consisting of 1218 bp coding for a 43·45 kDa RPP protein. The RPP protein assay results indicated that the highest RPP enzyme expression with 870 Soxhlet units (SU) per ml and 7914 SU/OD were obtained for cultures which were incubated at pH 5·5 and 30°C. Interestingly, milk coagulation was observed after 205 min of inoculating milk with recombinant L. lactis carrying the RPP gene. The recombinant L. lactis carrying RPP gene has the ability to function as a starter culture for acidifying and subsequently coagulating milk by producing RPP as a milk coagulant agent. Creating a recombinant starter culture bacterium that is able to coagulate milk. It is significant because the recombinant L. lactis has the ability to work as a starter culture and milk coagulation agent. © 2016 The Society for Applied Microbiology.

Feasibility and Acute Toxicity of Hypofractionated Radiation in Large-breasted Patients

Energy Technology Data Exchange (ETDEWEB)

Dorn, Paige L., E-mail: pdorn@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States); Corbin, Kimberly S.; Al-Hallaq, Hania; Hasan, Yasmin; Chmura, Steven J. [Department of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, IL (United States)

2012-05-01

Purpose: To determine the feasibility of and acute toxicity associated with hypofractionated whole breast radiation (HypoRT) after breast-conserving surgery in patients excluded from or underrepresented in randomized trials comparing HypoRT with conventional fractionation schedules. Methods and Materials: A review was conducted of all patients consecutively treated with HypoRT at University of Chicago. All patients were treated to 42.56 Gy in 2.66 Gy daily fractions in either the prone or supine position. Planning was performed in most cases using wedges and large segments or a 'field-in-field' technique. Breast volume was estimated using volumetric measurements of the planning target volume (PTV). Dosimetric parameters of heterogeneity (V105, V107, V110, and maximum dose) were recorded for each treatment plan. Acute toxicity was scored for each treated breast. Results: Between 2006 and 2010, 78 patients were treated to 80 breasts using HypoRT. Most women were overweight or obese (78.7%), with a median body mass index of 29.2 kg/m{sup 2}. Median breast volume was 1,351 mL. Of the 80 treated breasts, the maximum acute skin toxicity was mild erythema or hyperpigmentation in 70.0% (56/80), dry desquamation in 21.25% (17/80), and focal moist desquamation in 8.75% (7/80). Maximum acute toxicity occurred after the completion of radiation in 31.9% of patients. Separation >25 cm was not associated with increased toxicity. Breast volume was the only patient factor significantly associated with moist desquamation on multivariable analysis (p = 0.01). Patients with breast volume >2,500 mL experienced focal moist desquamation in 27.2% of cases compared with 6.34% in patients with breast volume <2,500 mL (p = 0.03). Conclusions: HypoRT is feasible and safe in patients with separation >25 cm and in patients with large breast volume when employing modern planning and positioning techniques. We recommend counseling regarding expected increases in skin toxicity in women

Argon plasma coagulation for a patient with locoregional failure after definitive chemoradiotherapy for esophageal carcinoma. A case report

International Nuclear Information System (INIS)

Nomura, Tsutomu; Miyashita, Masao; Makino, Hiroshi; Okawa, Keiichi; Katsuta, Miwako; Tajiri, Takashi

2008-01-01

Patients who undergo definitive chemoradiotherapy (CRT) face a risk of residual resistant disease or disease recurrence at the primary site; therefore, salvage treatment may be required. An optimum strategy to minimize these risks clearly needs to be established. Argon plasma coagulation (APC) is a safe and convenient procedure now applied widely for therapeutic endoscopy. In this report we describe the successful use of APC over 6 years for the treatment of recurrent esophageal cancer after CRT. A 61-year-old Japanese man underwent CRT for a thoracic esophageal cancer. Pathological examination before CRT revealed a well-differentiated squamous cell carcinoma. Locoregional failure was observed 2 years after CRT, and an initial APC treatment was performed. The patient has now undergone APC ablation 7 times with no postoperative complications. No metastasis to lymph nodes or to other organs has been detected during the last 6 years. The usefulness of APC as a salvage treatment for locoregional failure after definitive CRT has not been established. In our experience, salvage APC is the best treatment option for some patients. (author)

Critical assessment of chitosan as coagulant to remove cyanobacteria

NARCIS (Netherlands)

Lürling, Miquel; Noyma, Natalia Pessoa; Magalhães, Leonardo de; Miranda, Marcela; Mucci, Maíra; Oosterhout, Frank van; Huszar, Vera L.M.; Marinho, Marcelo Manzi

2017-01-01

Removal of cyanobacteria from the water column using a coagulant and a ballast compound is a promising technique to mitigate nuisance. As coagulant the organic, biodegradable polymer chitosan has been promoted. Results in this study show that elevated pH, as may be common during cyanobacterial

Critical assessment of chitosan as coagulant to remove cyanobacteria

NARCIS (Netherlands)

Lurling, Miguel; Noyma, Natalia Pessoa; Magalhães, de Leonardo; Miranda, Marcela; Mucci, Maíra; Oosterhout, van F.; Huszar, Vera L.M.; Marinho, Marcelo Manzi

2017-01-01

Removal of cyanobacteria from the water column using a coagulant and a ballast compound is a promising technique to mitigate nuisance. As coagulant the organic, biodegradable polymer chitosan has been promoted. Results in this study show that elevated pH, as may be common during cyanobacterial

Associations between hypo-HDL cholesterolemia and cardiometabolic risk factors in middle-aged men and women: Independence of habitual alcohol drinking, smoking and regular exercise.

Science.gov (United States)

Wakabayashi, Ichiro; Daimon, Takashi

Hypo-HDL cholesterolemia is a potent cardiovascular risk factor, and HDL cholesterol level is influenced by lifestyles including alcohol drinking, smoking and regular exercise. The aim of this study was to clarify the relationships between hypo-HDL cholesterolemia and cardiovascular risk factors and to determine whether or not these relationships depend on the above-mentioned lifestyles. The subjects were 3456 men and 2510 women (35-60 years of age) showing low HDL cholesterol levels (smoking and regular exercise (men, n=333; women, n=1410) and their age-matched control subjects were also analysed. Both in men and in women of overall subjects and subjects without histories of alcohol drinking, smoking and regular exercise, odds ratios of subjects with hypo-HDL cholesterolemia vs. subjects with normo-HDL cholesterolemia for high body mass index, high waist-to-height ratio, high triglycerides, high lipid accumulation product and multiple risk factors (three or more out of obesity, hypertension, dyslipidaemia and diabetes) were significantly higher than the reference level of 1.00. These associations in overall subjects were found when the above habits were adjusted. Hypo-HDL cholesterolemic men and women have adverse cardiovascular profiles, such as obesity, hypertriglyceridemia and multiple risk factors, independently of age, alcohol drinking, smoking and regular exercise. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Coagulation mechanism of salt solution-extracted active component in Moringa oleifera seeds

OpenAIRE

Okuda, Tetsuji; Baes, Aloysius U.; Nishijima, Wataru; Okada, Mitsumasa

2001-01-01

This study focuses on the coagulation mechanism by the purified coagulant solution (MOC-SC-PC) with the coagulation active component extracted from M. oleifera seeds using salt solution. The addition of MOC-SC-PC into tap water formed insoluble matters. The formation was responsible for kaolin coagulation. On the other hand, insoluble matters were not formed when the MOC-SC-PC was added into distilled water. The formation was affected by Ca2+ or other bivalent cations which may connect each m...

Improvement of extraction method of coagulation active components from Moringa oleifera seed

OpenAIRE

Okuda, Tetsuji; Baes, Aloysius U.; Nishijima, Wataru; Okada, Mitsumasa

1999-01-01

A new method for the extraction of the active coagulation component from Moringa oleifera seeds was developed and compared with the ordinary water extraction method (MOC–DW). In the new method, 1.0 mol l-1 solution of sodium chloride (MOC–SC) and other salts were used for extraction of the active coagulation component. Batch coagulation experiments were conducted using 500 ml of low turbid water (50 NTU). Coagulation efficiencies were evaluated based on the dosage required to remove kaolinite...

The Mast Cell, Contact, and Coagulation System Connection in Anaphylaxis

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Mar Guilarte

2017-07-01

Full Text Available Anaphylaxis is the most severe form of allergic reaction, resulting from the effect of mediators and chemotactic substances released by activated cells. Mast cells and basophils are considered key players in IgE-mediated human anaphylaxis. Beyond IgE-mediated activation of mast cells/basophils, further mechanisms are involved in the occurrence of anaphylaxis. New insights into the potential relevance of pathways other than mast cell and basophil degranulation have been unraveled, such as the activation of the contact and the coagulation systems. Mast cell heparin released upon activation provides negatively charged surfaces for factor XII (FXII binding and auto-activation. Activated FXII, the initiating serine protease in both the contact and the intrinsic coagulation system, activates factor XI and prekallikrein, respectively. FXII-mediated bradykinin (BK formation has been proven in the human plasma of anaphylactic patients as well as in experimental models of anaphylaxis. Moreover, the severity of anaphylaxis is correlated with the increase in plasma heparin, BK formation and the intensity of contact system activation. FXII also activates plasminogen in the fibrinolysis system. Mast cell tryptase has been shown to participate in fibrinolysis through plasmin activation and by facilitating the degradation of fibrinogen. Some usual clinical manifestations in anaphylaxis, such as angioedema or hypotension, or other less common, such as metrorrhagia, may be explained by the direct effect of the activation of the coagulation and contact system driven by mast cell mediators.

A Randomized, Double-Blind, Placebo-Controlled, Phase 2b Study to Evaluate the Safety and Efficacy of Recombinant Human Soluble Thrombomodulin, ART-123, in Patients With Sepsis and Suspected Disseminated Intravascular Coagulation

NARCIS (Netherlands)

Vincent, Jean-Louis; Ramesh, Mayakonda K.; Ernest, David; Larosa, Steven P.; Pachl, Jan; Aikawa, Naoki; Hoste, Eric; Levy, Howard; Hirman, Joe; Levi, Marcel; Daga, Mradul; Kutsogiannis, Demetrios J.; Crowther, Mark; Bernard, Gordon R.; Devriendt, Jacques; Puigserver, Joan Vidal; Blanzaco, Daniel U.; Esmon, Charles T.; Parrillo, Joseph E.; Guzzi, Louis; Henderson, Seton J.; Pothirat, Chaicharn; Mehta, Parthiv; Fareed, Jawed; Talwar, Deepak; Tsuruta, Kazuhisa; Gorelick, Kenneth J.; Osawa, Yutaka; Kaul, Inder

2013-01-01

Objectives: To determine the safety and efficacy of recombinant thrombomodulin (ART-123) in patients with suspected sepsis-associated disseminated intravascular coagulation. Design: Phase 2b, international, multicenter, double-blind, randomized, placebo-controlled, parallel group, screening trial.

OPTIMISATION OF HIBISCUS SABDARIFFA AS A NATURAL COAGULANT TO TREAT CONGO RED IN WASTEWATER

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MUN Y. YONG

2016-02-01

Full Text Available The process of coagulation is commonly practiced in water and wastewater treatment to reduce level of dissolved chemical, turbidity and so on with the usage of coagulant. Aluminium sulphate (alum is the most commonly used coagulant, however, recent studies show that residual aluminium in drinking water and sludge may induce Alzheimer’s disease and environmental issues. Natural coagulant which is environmental friendly and non-toxic is developed as an alternative to overcome these issues. In this work, Hibiscus Sabdariffa was studied as natural coagulant to treat dye wastewater containing Congo red. The seeds were extracted with different solvent such as distilled water, 0.5 M NaCl and 0.05 M NaOH to extract the coagulation agent. The working parameters were optimised using Response Surface Methodology (RSM. 0.5 M NaCl was found to have highest colour removal of 95.1 % among the solvents. In addition, Hibiscus Sabdariffa seed was found to be an effective coagulant that has 91.2 % colour removal at the optimal working condition of pH 2, 190 mg/L coagulant dosage at 400 ppm of dye concentration. It was also been identified that the performance of natural coagulant is comparable with conventional coagulant, aluminium sulphate with colour removal of 91.2 % and 92.3 % respectively.

Removal of Arsenic from Drinking Water by Adsorption and Coagulation

Science.gov (United States)

Zhang, M.; Sugita, H.; Hara, J.; Takahashi, S.

2013-12-01

Removal of arsenic from drinking water has been an important issue worldwide, which has attracted greater attentions in recent years especially for supplying safe drinking water in developing countries. Although many kinds of treatment approaches that are available or applicable both in principle and practice, such as adsorption, coagulation, membrane filtration, ion exchange, biological process, electrocoagulation and so on, the first 2 approaches (i.e., adsorption and coagulation) are most promising due to the low-cost, high-efficiency, simplicity of treating systems, and thus can be practically used in developing countries. In this study, a literature survey on water quality in Bangladesh was performed to understand the ranges of arsenic concentration and pH of groundwater in Bangladesh. A series of tests were then organized and performed to investigate the effects of arsenic concentration, arsenic forms, pH, chemical compositions of the materials used for adsorption and coagulation, particle size distribution and treatment time on quality of treated water. The experimental results obtained in the study illustrated that both adsorption and coagulation can be used to effectively reduce the concentrations of either arsenic (V) or arsenic (III) from the contaminated water. Coagulation of arsenic with a magnesium-based material developed in this study can be very effective to remove arsenic, especially arsenic (V), from contaminated water with a concentration of 10 ppm to an undetectable level of 0.002 ppm by ICP analyses. Compared to arsenic (III), arsenic (V) is easier to be removed. The materials used for adsorption and coagulation in this study can remove arsenic (V) up to 9 mg/g and 6 mg/g, and arsenic (III) up to 4 mg/g and 3 mg/g, respectively, depending on test conditions and compositions of the materials being used. The control of pH during treatment can be a challenging technical issue for developing both adsorbent and coagulant. Keywords: Water Treatment

Effects of Puff-Adder Venom on Coagulation, Fibrinolysis and ...

African Journals Online (AJOL)

The in vitro and in vivo haematological effects of puffadder (Bitis arietans) venom in the baboon (Papio ursinus) with regard to its effect on coagulation, fibrinolysis and platelet aggregation were studied. There is a delay in the intrinsic coagulation mechanism with fibrinolysis and in vitro fibrinogenolysis. Normal human ...

Distribution functions and moments in the theory of coagulation

International Nuclear Information System (INIS)

Pich, J.

1990-04-01

Different distribution functions and their moments used in the Theory of coagulation are summarized and analysed. Relations between the moments of these distribution functions are derived and the physical meaning of individual moments is briefly discussed. The time evolution of the moment of order zero (total number concentration) during the coagulation process is analysed for the general kernel of the Smoluchowski equation. On this basis the time evolution of certain physically important quantities related to this moment such as mean particle size, surface and volume as well as surface concentration is described. Equations for the half time of coagulation for the general collision frequency factor are derived. (orig.) [de

Vasomotor response of the human face: laser-Doppler measurements during mild hypo- and hyperthermia.

Science.gov (United States)

Rasch, W; Cabanac, M

1993-04-01

The skin of the face is reputed not to vasoconstrict in response to cold stress because the face skin temperature remains steady during hypothermia. The purpose of the present work was to measure the vasomotor response of the human face to whole-body hypothermia, and to compare it with hyperthermia. Six male subjects were immersed in cold and in warm water to obtain the two conditions. Skin blood flow, evaporation, and skin temperature (Tsk) were recorded in three loci of the face, the forehead, the infra orbital area, and the cheek. Tympanic (Tty) and oesophageal (Toes) temperatures were also recorded during the different thermal states. Normothermic measurements served as control. Blood flow was recorded with a laser-Doppler flowmeter, evaporation measured with an evaporimeter. Face Tsk remained stable between normo-, hypo-, and hyperthermia. Facial blood flow, however, did not follow the same pattern. The facial blood flow remained at minimal vasoconstricted level when the subjects' condition was changed from normo- to hypothermia. When the condition changed from hypo- to hyperthermia a 3 to 9-fold increase in the blood flow was recorded. From these results it was concluded that a vasoconstriction seems to be the general vasomotor state in the face during normothermia.

A quantitative comparison between electrocoagulation and chemical coagulation for boron removal from boron-containing solution

International Nuclear Information System (INIS)

Yilmaz, A. Erdem; Boncukcuoglu, Recep; Kocakerim, M. Muhtar

2007-01-01

This paper provides a quantitative comparison of electrocoagulation and chemical coagulation approaches based on boron removal. Electrocoagulation process delivers the coagulant in situ as the sacrificial anode corrodes, due to a fixed current density, while the simultaneous evolution of hydrogen at the cathode allows for pollutant removal by flotation. By comparison, conventional chemical coagulation typically adds a salt of the coagulant, with settling providing the primary pollutant removal path. Chemical coagulation was carried out via jar tests using aluminum chloride. Comparison was done with the same amount of coagulant between electrocoagulation and chemical coagulation processes. Boron removal obtained was higher with electrocoagulation process. In addition, it was seen that chemical coagulation has any effect for boron removal from boron-containing solution. At optimum conditions (e.g. pH 8.0 and aluminum dose of 7.45 g/L), boron removal efficiencies for electrocoagulation and chemical coagulation were 94.0% and 24.0%, respectively

A quantitative comparison between electrocoagulation and chemical coagulation for boron removal from boron-containing solution

Energy Technology Data Exchange (ETDEWEB)

Yilmaz, A. Erdem [Atatuerk University, Faculty of Engineering, Department of Environmental Engineering, 25240 Erzurum (Turkey)], E-mail: aerdemy@atauni.edu.tr; Boncukcuoglu, Recep [Atatuerk University, Faculty of Engineering, Department of Environmental Engineering, 25240 Erzurum (Turkey); Kocakerim, M. Muhtar [Atatuerk University, Faculty of Engineering, Department of Chemical Engineering, 25240 Erzurum (Turkey)

2007-10-22

This paper provides a quantitative comparison of electrocoagulation and chemical coagulation approaches based on boron removal. Electrocoagulation process delivers the coagulant in situ as the sacrificial anode corrodes, due to a fixed current density, while the simultaneous evolution of hydrogen at the cathode allows for pollutant removal by flotation. By comparison, conventional chemical coagulation typically adds a salt of the coagulant, with settling providing the primary pollutant removal path. Chemical coagulation was carried out via jar tests using aluminum chloride. Comparison was done with the same amount of coagulant between electrocoagulation and chemical coagulation processes. Boron removal obtained was higher with electrocoagulation process. In addition, it was seen that chemical coagulation has any effect for boron removal from boron-containing solution. At optimum conditions (e.g. pH 8.0 and aluminum dose of 7.45 g/L), boron removal efficiencies for electrocoagulation and chemical coagulation were 94.0% and 24.0%, respectively.

Arsenic removal in water by means of coagulation-flocculation processes

International Nuclear Information System (INIS)

Franco, M. F.; Carro P, M. E.

2014-01-01

Arsenic and arsenical compounds are considered as carcinogenic and risky for humans according to epidemiological evidence related with the ingestion of arsenical water during a long period. In many places the only source of drinking water contains arsenic and, therefore, removal strategies have to be investigated. This work shows experimental results of coagulation-flocculation processes implemented to evaluate the efficiency in the removal of arsenic from drinking water. The main objectives include the evaluation of the relevant aspect that controls the removal efficiency. Experimental tests were performed with coagulant concentrations from 5 to 500 mg/L, solid particle concentrations from 0 to 6000 mg/L, and initial arsenic concentrations from 0.5 to 5 mg/L. These variables were simultaneously varied in more than 100 experiments. The efficiency in remediation ranged from 0% to 95%. Removal efficiency near 95% was obtained when using ferric chloride as coagulant, and was close to 80% when using aluminium sulfate as coagulant in arsenate solutions. The remediation efficiency decreased significantly when the ferric chloride concentration was higher than 50 mg/L in relation to the obtained results for aluminum sulfate for different type and concentration of soil particles. The highest removal efficiency were obtained at ph between 3 and 5 in oxidized solutions. Obtained results simulated by means of multiple linear regression analysis (R>0.90) allow determining that the main parameters that control the removal of arsenic from drinking water are coagulant concentration, ph, and solid particles concentration. Conversely, particle mineralogy and coagulant type have less significant effect on the removal by means of coagulation-flocculation mechanisms. Obtained results are relevant for the removal of As in water treatment plants as well as for the development of small scale filters. The samples were studied by scanning electron microscopy and energy dispersive X

Patient-important outcomes in randomized controlled trials in critically ill patients: a systematic review.

Science.gov (United States)

Gaudry, Stéphane; Messika, Jonathan; Ricard, Jean-Damien; Guillo, Sylvie; Pasquet, Blandine; Dubief, Emeline; Boukertouta, Tanissia; Dreyfuss, Didier; Tubach, Florence

2017-12-01

Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. Literature search was conducted to identify eligible trials indexed from January to December 2013. Articles were eligible if they reported an RCT involving critically ill adult patients. We excluded phase II, pilot and physiological crossover studies. We assessed study characteristics. All primary and secondary outcomes were collected, described and classified using six categories of outcomes including patient-important outcomes (involving mortality at any time on the one hand and quality of life, functional/cognitive/neurological outcomes assessed after ICU discharge on the other). Of the 716 articles retrieved in 2013, 112 RCTs met the inclusion criteria. Most common topics were mechanical ventilation (27%), sepsis (19%) and nutrition (17%). Among the 112 primary outcomes, 27 (24%) were patient-important outcomes (mainly mortality, 21/27) but only six (5%) were patient-important outcomes besides mortality assessed after ICU discharge (functional disability = 4; quality of life = 2). Among the 598 secondary outcomes, 133 (22%) were patient-important outcomes (mainly mortality, 92/133) but only 41 (7%) were patient-important outcomes besides mortality assessed after ICU discharge (quality of life = 20, functional disability = 14; neurological/cognitive performance = 5; handicap = 1; post-traumatic stress = 1). Seventy-three RCTs (65%) reported at least one patient-important outcome but only 11 (10%) reported at least one patient-important outcome besides mortality assessed after ICU discharge. Patient-important outcomes are rarely primary

Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

Science.gov (United States)

Wysham, Nicholas G; Abernethy, Amy P; Cox, Christopher E

2014-10-01

Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU. Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction. A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.

Comparison of postoperative coagulation profiles and outcome for sugammadex versus pyridostigmine in 992 living donors after living-donor hepatectomy.

Science.gov (United States)

Moon, Young-Jin; Kim, Sung-Hoon; Kim, Jae-Won; Lee, Yoon-Kyung; Jun, In-Gu; Hwang, Gyu-Sam

2018-03-01

Donor safety is the major concern in living donor liver transplantation, although hepatic resection may be associated with postoperative coagulopathy. Recently, the use of sugammadex has been gradually increased, but sugammadex is known to prolong prothrombin time (PT) and activated partial thromboplastin time (aPTT). We compared the postoperative coagulation profiles and outcomes of sugammadex versus pyridostigmine group in donors receiving living donor hepatectomy.Consecutive donor hepatectomy performed between September 2013 and August 2016 was retrospectively analyzed. For reversal of rocuronium-induced neuromuscular blockade, donors received sugammadex 4 mg/kg or pyridostigmine 0.25 mg/kg. The primary end-points were laboratory findings (PT, aPTT, hemoglobin, platelet count) and clinically evaluated postoperative bleeding (relaparotomy for bleeding, cumulative volume collected in drains). Secondary outcomes were anesthesia time, postoperative hospital day.Of 992 donors, 383 treated with sugammadex and 609 treated with pyridostigmine for the reversal of neuromuscular blockade. There were no significant differences between both groups for drop in hemoglobin and platelet, prolongation in PT, aPTT, and the amount of 24-h drain volume. Bleeding events within 24 h were reported in 2 (0.3%) for pyridostigmine group and 0 (0%) for sugammadex group (P = .262). Anesthesia time was significantly longer in pyridostigmine group than that in sugammadex group (438.8 ± 71.4 vs. 421.3 ± 62.3, P sugammadex group (P = .002).Sugammadex 4 mg/kg was not associated with increased bleeding tendency, but associated with reduced anesthesia time and hospital stay. Therefore, sugammadex may be safely used and will decrease morbidity in donor undergoing living-donor hepatectomy.

Effect of THI on milk coagulation properties of Holstein-Friesian dairy cattle

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Simone Beux

Full Text Available ABSTRACT The objective of this study was to evaluate the effect of temperature-humidity index (THI on the milk coagulation properties of Holstein-Friesian dairy cattle from northeast part of Italy. A total of 592 individual milk samples from six dairy herds were evaluated. The milk coagulation properties traits analysed were milk rennet coagulation time and curd firmness, as well as the fat, protein, and casein contents, pH, milk aptitude to coagulate (IAC, and the somatic cell count. The THI was determined during the periods of sample collection. The THI results showed that values of up to 75 did not significantly change the IAC values; however, when the THI values were above 75, the IAC decreased significantly. The control of THI can be used to guarantee appropriate milk coagulation properties.

Application of Moringa Oleifera Seed Powder For Iron (III Coagulation on Local Water Resources

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Fadillah Utami Prasetyaningtyas

2013-07-01

Full Text Available This research aims to know the effect of the use of powder moringa seed to coagulant mass and coagulation process, and its effectiveness to increase the quality of pure water. This research uses factorial research design and statistic test MANOVA. To analyse water quality, the researcher uses Fe parameter.  A graphic of coagulant mass and time for each parameter is used to analyse the data. Based on the research result, the uses of moringa seed as coagulant in each 300 mL mineral water gives a possitives result to the river water sample using 100 mg coagulant mass and sedimentations time for 60 minutes, well water sample using 500 mg coagulant mass and sedimentations time for 60 minutes, tap water sample using 300 mg  coagulant mass and sedimentations time for 90 minutes. The effective coagulant that increase the water quality on well water is 98,32% of moringa seed powder, on river water is 96,64%  and for tap water is 25,62%.

Influential factors of formation kinetics of flocs produced by water treatment coagulants.

Science.gov (United States)

Wu, Chunde; Wang, Lin; Hu, Bing; Ye, Jian

2013-05-01

The growth rate and size of floc formation is of great importance in water treatment especially in coagulation process. The floc formation kinetics and the coagulation efficiency of synthetic water were investigated by using an on-line continuous optical photometric dispersion analyze and the analysis of water quality. Experimental conditions such as alum dosage, pH value for coagulation, stirring intensity and initial turbidity were extensively examined. The photometric dispersion analyze results showed that coagulation of kaolin suspensions with two coagulants (alum and polyaluminium chloride) could be taken as a two-phase process: slow and rapid growth periods. Operating conditions with higher coagulant doses, appropriate pH and average shear rate might be particularly advantageous. The rate of overall floc growth was mainly determined by a combination of hydraulic and water quality conditions such as pH and turbidity. The measurement of zeta potential indicates that polyaluminium chloride exhibited higher charge-neutralizing ability than alum and achieved lower turbidities than alum for equivalent Al dosages. Under the same operating conditions, the alum showed a higher grow rate, but with smaller floc size.

Coagulation-flocculation studies of laboratory wastewater using different combinations

International Nuclear Information System (INIS)

Butt, M. T.; Khan, R. A.; Khokar, A.; Iqbal, K.

2013-01-01

This study was conducted on the wastewater of PCSIR Laboratories complex Lahore. Both single as well as blended form was used in order to achieve maximum results and to reduce the cost. These experiments were conducted in Hudson Jars of one liter capacity using the coagulation technique for the removal of total suspended solids (TSS) and turbidity. The pH range was 6-8 and 4-10 for treatment. Four coagulants were used such as FeCl 3 , AlCl 3 . Alum and FeSO 4 , to remove the turbidity in single and blended form. Results of single coagulant are FeCl 3 from 39.7 to 11.51 NTU; AlCl 3 from 47.48 to 11.8 NTU. Alum 43 to 25.3NTU.FeSO 4 showed increasing trend in turbidity 53 to 120 NTU. The blended set of coagulants AlCl 3 +Alum turbidity from 45 to 18.55 NTU. The AlCl 3 and FeCl 3 showed almost similar results but after overnight settling results were excellent and alum showed also good results. The turbidity was removed from 54 to 27 NTU, 48 to 22 NTU, 44 to 17 NTU, and after overnight settling 33 to 4 NTU. The results of blended coagulants FeCl 3 +AlCl 3 after one, two and three hours settling were also studied and found best and blend AlCl3+Alum showed also similar trend and the blend of Alum+FeCl 3 after overnight settling was excellent. The same coagulants and its blended form were used for TSS removal and results are 278 to 7 mg/L, in blended form AlCl 3 +Alum show similar results but Alum + FeCl 3 showed excellent results. The TSS and turbidity removal was 87%, 97.5%. (author)

Downregulation of the taurine transporter TauT during hypo-osmotic stress in NIH3T3 mouse fibroblasts

DEFF Research Database (Denmark)

Hansen, Daniel Bloch; Friis, Martin Barfred; Hoffmann, Else Kay

2012-01-01

The present work was initiated to investigate regulation of the taurine transporter TauT by reactive oxygen species (ROS) and the tonicity-responsive enhancer binding protein (TonEBP) in NIH3T3 mouse fibroblasts during acute and long-term (4 h) exposure to low-sodium/hypo-osmotic stress. Taurine...... are significantly increased following hyperosmotic exposure. Swelling-induced ROS production in NIH3T3 fibroblasts is generated by NOX4 and by increasing total ROS, by either exogenous application of H(2)O(2) or overexpressing NOX4, we demonstrate that TonEBP activity and taurine influx are regulated negatively...... by ROS under hypo-osmotic, low-sodium conditions, whereas the TauT mRNA level is unaffected. Acute exposure to ROS reduces taurine uptake as a result of modulated TauT transport kinetics. Thus, swelling-induced ROS production could account for the reduced taurine uptake under low...

Evaluation of Chitin as Natural Coagulant in Water Treatment

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V. Saritha

2012-04-01

Full Text Available The use of synthetic coagulants is not regarded as suitable due to health and economic considerations. The present study was aimed to investigate the effects of alum as coagulant in conjunction with chitin as coagulant aid on the removal of turbidity, hardness and Escherichia coli from water. A conventional jar test apparatus was employed for the tests. The experiment was conducted at three different pH conditions of 6, 7 and 8. The dosages chosen were 0.5, 1, 1.5 and 2mg/l. The results showed that turbidity decrease provided also a primary Escherichia coli reduction. Hardness removal efficiency was observed to be 93% at pH 7 with 1mg/l concentration by alum whereas chitin was stable at all the pH ranges showing highest removal at 1 and 1.5mg/l with pH 7. At low concentration chitin showed marginally better performance on hardness. In conclusion, using natural coagulants results in considerable savings in chemicals and sludge handling cost may be achieved.

Use of non-Conventional Material to Remove Cu+2 ions from Aqueous Solutions using Chemical Coagulation

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Muna Yousif Abdul. Ahad

2015-05-01

Full Text Available Coagulation - flocculation are basic chemical engineering method in the treatment of metal-bearing industrial wastewater because it removes colloidal particles, some soluble compounds and very fine solid suspensions initially present in the wastewater by destabilization and formation of flocs. This research was conducted to study the feasibility of using natural coagulant such as okra and mallow and chemical coagulant such as alum for removing Cu and increase the removal efficiency and reduce the turbidity of treated water. Fourier transform Infrared (FTIR was carried out for okra and mallow before and after coagulant to determine their type of functional groups. Carbonyl and hydroxyl functional groups on the surface of okra and mallow were the major groups responsible for coagulation process. By using alum (conventional coagulants, okra and mallow (as a primary coagulant or in combination with the other two primary coagulants and by the jar testing, the optimum pH-value and dose of the coagulants were determined. The results indicated that the optimal pH values were 6.7, 8 and 6 for alum, okra and mallow, respectively. Mathematical modeling show significant results (sig.<0.05 for the % Cu removal (dependent variable with respect to coagulant dose (independent variable for the okra as a primary coagulant, alum with okra and alum with mallow as binary coagulants and alum, okra and mallow as ternary coagulants .

Blood coagulation factor VIII

Indian Academy of Sciences (India)

Factor VIII (FVIII) functions as a co-factor in the blood coagulation cascade for the proteolytic activation of factor X by factor IXa. Deficiency of FVIII causes hemophilia A, the most commonly inherited bleeding disorder. This review highlights current knowledge on selected aspects of FVIII in which both the scientist and the ...

An assessment of thromboelastometry to monitor blood coagulation and guide transfusion support in liver transplantation.

Science.gov (United States)

Blasi, Annabel; Beltran, Joan; Pereira, Arturo; Martinez-Palli, Graciela; Torrents, Abiguei; Balust, Jaume; Zavala, Elizabeth; Taura, Pilar; Garcia-Valdecasas, Juan-Carlos

2012-09-01

Rotation thromboelastometry (TEM) has been proposed as a convenient alternative to standard coagulation tests in guiding the treatment of coagulopathy during orthotopic liver transplantation (OLT). This study was aimed at assessing the value of TEM in monitoring blood coagulation and guide transfusion support in OLT. Standard coagulation and TEM (EXTEM and FIBTEM) tests were performed at four preestablished intraoperative time points in 236 OLTs and prospectively recorded in a dedicated database together with the main operative and transfusion data. Transfusion thresholds were based on standard coagulation tests. Spearman's rank correlation (ρ), linear regression, and receiver operating characteristic curves were used when appropriate. EXTEM maximum clot firmness (MCF(EXTEM)) was the TEM variable that best correlated with the platelet (PLT) and fibrinogen levels (ρ = 0.62 and ρ = 0.69, respectively). MCF(FIBTEM) correlated with fibrinogen level (ρ = 0.70). EXTEM clot amplitude at 10 minutes (A10(EXTEM)) was a good linear predictor of MCF(EXTEM) (R(2) =0.93). The cutoff values that best predicted the transfusion threshold for PLTs and fibrinogen were A10(EXTEM) = 35 mm and A10(FIBTEM) = 8 mm. At these values, the negative and positive predictive accuracies of TEM to predict the transfusion thresholds were 95 and 27%, respectively. A10(EXTEM) is an adequate TEM variable to guide therapeutic decisions during OLT. Patients with A10(EXTEM) of greater than 35 mm are unlikely to bleed because of coagulation deficiencies, but using A10(EXTEM) of not more than 35 mm as the sole transfusion criterion can lead to unnecessary utilization of PLTs and fibrinogen-rich products. © 2012 American Association of Blood Banks.

Removal of algal blooms from freshwater by the coagulation-magnetic separation method.

Science.gov (United States)

Liu, Dan; Wang, Peng; Wei, Guanran; Dong, Wenbo; Hui, Franck

2013-01-01

This research investigated the feasibility of changing waste into useful materials for water treatment and proposed a coagulation-magnetic separation technique. This technique was rapid and highly effective for clearing up harmful algal blooms in freshwater and mitigating lake eutrophication. A magnetic coagulant was synthesized by compounding acid-modified fly ash with magnetite (Fe(3)O(4)). Its removal effects on algal cells and dissolved organics in water were studied. After mixing, coagulation, and magnetic separation, the flocs obtained from the magnet surface were examined by SEM. Treated samples were withdrawn for the content determination of chlorophyll-a, turbidity, chemical oxygen demand (COD), total nitrogen, and total phosphorus. More than 99 % of algal cells were removed within 5 min after the addition of magnetic coagulant at optimal loadings (200 mg L(-1)). The removal efficiencies of COD, total nitrogen, and phosphorus were 93, 91, and 94 %, respectively. The mechanism of algal removal explored preliminarily showed that the magnetic coagulant played multiple roles in mesoporous adsorption, netting and bridging, as well as high magnetic responsiveness to a magnetic field. The magnetic-coagulation separation method can rapidly and effectively remove algae from water bodies and greatly mitigate eutrophication of freshwater using a new magnetic coagulant. The method has good performance, is low cost, can turn waste into something valuable, and provides reference and directions for future pilot and production scale-ups.

PILOT PLANT STUDY ON NATURAL WATER COAGULANTS AS COAGULAN AIDS FOR WATER SUPPLY

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B BINA

2001-06-01

Full Text Available Introduction: Natural plant coagulants have an important role to play in provision of portable water to rural communities in the developing world. The plant material that their coagulation properties have been confirmed in previous lab scale studies and can be found widely in Iran was selected as coagulant aids. Pilot plant study was done to evaluate the efficiency of natural material such as Starch/Gum Tragacanth, Fenugreek and Yeast as coagulant aids in conjunction with comercial alum. Methods: The pilot was placed in Isfahan Water Treatment Plant (IWTP and efficiency of these materials in removal of turbidity from raw water enters the IWTP was evaluated. The results indicated while these materials were used as coagulant aids in concentration of 1-5 mg/l conjunction with alum are able to reduced the turbidity and final residuals turbidity meets the standards limits. Results: The coagulation efficiency of these material were found to be effected by certain physico-chemical factors, namely, concentration of suspended solids, divalent cation metal and time of agitation. The relative importance of these variable was evaluated. The results of COD test proved that the natural coagulant aids in the optimum doses produce no any significant organic residual. Discussion: Economical considerations showed that using of these material as coagulant aids can cause reduction in alum consumption and in some cases are more econmical than synthetic polyelectrolyte.

Relative hypo- and hypercortisolism are both associated with depression and lower quality of life in bipolar disorder: a cross-sectional study.

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Martin Maripuu

Full Text Available BACKGROUND: Depression in unipolar and bipolar disorders is associated with hypothalamic-pituitary-adrenal-axis (HPA-axis hyperactivity. Also, unipolar disorder has recently been shown to exhibit HPA-axis hypoactivity. We studied for the first time how HPA-axis hypo- and hyperactivity relate to depression and disease burden in bipolar disorder. We were interested in studying hypocortisolism; characterized by increased HPA-axis negative feedback sensitivity and lower basal cortisol levels together with the opposite HPA-axis regulatory pattern of hypercortisolism. METHODS: This cross-sectional study includes 145 type 1 and 2 bipolar outpatients and 145 matched controls. A dexamethasone-suppression-test (DST measures the negative feedback sensitivity and a weight-adjusted very-low-dose DST was employed, which is sensitive in identifying hypocortisolism and hypercortisolism. The 25th and 75th percentiles of control post-DST values were used as cut-offs identifying patients exhibiting relative hypo-, and hypercortisolism. Self-report questionnaires were employed: Beck-Depression-Inventory (BDI, Montgomery-Åsberg-Depression-Rating-Scale (MADRS-S, World-Health-Organization-Quality-of-Life-Assessment-100 and Global-Assessment-of-Functioning. RESULTS: Patients exhibiting relative hypocortisolism expectedly exhibited lowered basal cortisol levels (p = 0.046. Patients exhibiting relative hypercortisolism expectedly exhibited elevated basal levels (p<0.001. Patients exhibiting relative hypocortisolism showed 1.9-2.0 (BDI, p = 0.017, MADRS-S, p = 0.37 and 6.0 (p<0.001 times increased frequencies of depression and low overall life quality compared with patients exhibiting mid post-DST values (eucortisolism. Adjusted Odds Ratios (OR:s for depression ranged from 3.8-4.1 (BDI, p = 0.006, MADRS-S, p = 0.011 and was 23.4 (p<0.001 for life quality. Patients exhibiting relative hypercortisolism showed 1.9-2.4 (BDI, p = 0.017, MADRS-S, p�

A new inorganic-organic composite coagulant, consisting of polyferric sulphate (PFS) and polyacrylamide (PAA).

Science.gov (United States)

Moussas, P A; Zouboulis, A I

2009-08-01

Currently, research is focused on the synthesis of new composite coagulants, which are constituted of both inorganic and organic materials. In this paper, the development of relevant reagents was investigated, by combining the inorganic pre-polymerised iron-based coagulant Polyferric Sulphate (PFS) with an organic, non-ionic polymer (Polyacrylamide, PAA) under different PAA/Fe (mg/l) and OH/Fe molar ratios. Moreover, the new reagents were characterised in terms of typical properties, stability and morphological analysis (XRD, FTIR, SEM). Their coagulation performance, when treating low or high turbid kaolin-humic acid suspensions, was also investigated, whereas the applied coagulation mechanisms were discussed by using the Photometric Dispersion Analysis (PDA) analysis. The results show that the new coagulation reagents present improved properties, including increased effective polymer species concentration, and they exhibit very good stability. The respective tests using PDA confirmed that the predominant coagulation mechanism of PFS-PAA is the bridge formation mechanism. Coagulation experiments in low or high turbid kaolin-humic acid suspensions reveal that the novel composite reagent PFS-PAA exhibits better coagulation performance, when compared with simple PFS, in terms of zeta-potential reduction, turbidity and organic matter removal and residual iron concentration.

Exact combinatorial approach to finite coagulating systems

Science.gov (United States)

Fronczak, Agata; Chmiel, Anna; Fronczak, Piotr

2018-02-01

This paper outlines an exact combinatorial approach to finite coagulating systems. In this approach, cluster sizes and time are discrete and the binary aggregation alone governs the time evolution of the systems. By considering the growth histories of all possible clusters, an exact expression is derived for the probability of a coagulating system with an arbitrary kernel being found in a given cluster configuration when monodisperse initial conditions are applied. Then this probability is used to calculate the time-dependent distribution for the number of clusters of a given size, the average number of such clusters, and that average's standard deviation. The correctness of our general expressions is proved based on the (analytical and numerical) results obtained for systems with the constant kernel. In addition, the results obtained are compared with the results arising from the solutions to the mean-field Smoluchowski coagulation equation, indicating its weak points. The paper closes with a brief discussion on the extensibility to other systems of the approach presented herein, emphasizing the issue of arbitrary initial conditions.

Nurse working conditions and patient safety outcomes.

Science.gov (United States)

Stone, Patricia W; Mooney-Kane, Cathy; Larson, Elaine L; Horan, Teresa; Glance, Laurent G; Zwanziger, Jack; Dick, Andrew W

2007-06-01

System approaches, such as improving working conditions, have been advocated to improve patient safety. However, the independent effect of many working condition variables on patient outcomes is unknown. To examine effects of a comprehensive set of working conditions on elderly patient safety outcomes in intensive care units. Observational study, with patient outcome data collected using the National Nosocomial Infection Surveillance system protocols and Medicare files. Several measures of health status and fixed setting characteristics were used to capture distinct dimensions of patient severity of illness and risk for disease. Working condition variables included organizational climate measured by nurse survey; objective measures of staffing, overtime, and wages (derived from payroll data); and hospital profitability and magnet accreditation. The sample comprised 15,846 patients in 51 adult intensive care units in 31 hospitals depending on the outcome analyzed; 1095 nurses were surveyed. Central line associated bloodstream infections (CLBSI), ventilator-associated pneumonia, catheter-associated urinary tract infections, 30-day mortality, and decubiti. Units with higher staffing had lower incidence of CLBSI, ventilator-associated pneumonia, 30-day mortality, and decubiti (P working conditions were associated with all outcomes measured. Improving working conditions will most likely promote patient safety. Future researchers and policymakers should consider a broad set of working condition variables.

Vegetable coagulants as alternative for treatment of wastewater in Mexico

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Servando López-León

2017-11-01

Full Text Available This review addresses the various properties of natural coagulants, water, the chemical substance essential for life and the ideal solvent for a large number of compounds, it is commonly used with domestic, commercial and industrial purposes. After its use, it presents sewage to be retired before use it once again. To remove pollutant, water is subject to different physical, chemical and biological processes. Here, the clarification process uses aluminum and iron materials to remove the solids present; these materials are reported as health hazardous and toxic. In Mexico, regulatory frame work stablish that treated wastewater should do not exceed 0.2 mg/L of aluminum even though has been reported an increased risk of Alzheimer's in populations when water exceeds 0.1 mg/L. Natural coagulants have showed coagulation properties when are used in the clarification process, proven its advantages over traditional ones; such as low cost, good coagulant properties and safe health and non-toxic properties. Here, we enlist some vegetable species as alternatives to the traditional based on aluminum and iron. Additionally, these species are known to have origins on Mexico or being present extensively in the territory, making possible to think about them as alternative coagulants in the clarification process of the wastewater treatment process.

Outcomes-focused knowledge translation: a framework for knowledge translation and patient outcomes improvement.

Science.gov (United States)

Doran, Diane M; Sidani, Souraya

2007-01-01

Regularly accessing information that is current and reliable continues to be a challenge for front-line staff nurses. Reconceptualizing how nurses access information and designing appropriate decision support systems to facilitate timely access to information may be important for increasing research utilization. An outcomes-focused knowledge translation framework was developed to guide the continuous improvement of patient care through the uptake of research evidence and feedback data about patient outcomes. The framework operationalizes the three elements of the PARIHS framework at the point of care. Outcomes-focused knowledge translation involves four components: (a) patient outcomes measurement and real-time feedback about outcomes achievement; (b) best-practice guidelines, embedded in decision support tools that deliver key messages in response to patient assessment data; (c) clarification of patients' preferences for care; and (d) facilitation by advanced practice nurses and practice leaders. In this paper the framework is described and evidence is provided to support theorized relationships among the concepts in the framework. The framework guided the design of a knowledge translation intervention aimed at continuous improvement of patient care and evidence-based practice, which are fostered through real-time feedback data about patient outcomes, electronic access to evidence-based resources at the point of care, and facilitation by advanced practice nurses. The propositions in the framework need to be empirically tested through future research.

Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? A prospective observational study

DEFF Research Database (Denmark)

Johansson, Per Ingemar; Sorensen, Anne Marie; Perner, Anders

2011-01-01

ABSTRACT: INTRODUCTION: It is debated whether the early trauma induced coagulopathy (TIC) in severely injured patients reflects disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype, acute coagulopathy of trauma shock (ACoTS) or yet other entities. This study investigated the...

Recombinant-activated factor VII in patients with uncontrolled bleeding: A retrospective observational analysis

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Said D Abuhasna

2012-01-01

Full Text Available Background: Factor VIIa (recombinant has an off-label use to control life-threatening bleeding that is refractory to other measures and was shown to decrease transfusion requirements. Objective: The primary objective of this study was to assess the safety and effectiveness of factor VIIa (recombinant on blood transfusion requirements and coagulation parameters when used in patients whose bleeding was uncorrected by other means. The pharmacoeconomic impact for any discrepancy from our protocol was evaluated. Secondary outcomes included 4-hour and 28-day mortality, as well as safety of this agent in terms of thromboembolic complications. Materials and Methods: We retrospectively evaluated patients who received recombinant-activated factor VII (rFVIIa for uncontrolled bleeding from June 2008 to April 2011. The medical records of 33 patients were evaluated. Coagulation parameters and blood products were determined 24 hours before and 24 hours after administration of rFVIIa, and the results compared. Patients were also screened for any thromboembolic complications. Results: Administration of rFVIIa reduced blood transfusion requirements and improved coagulation parameters significantly (P<0.05. No thromboembolic complications were reported. Most of the dosing was consistent with those recommended in our institutional protocol, with discrepancies resulting in an average cost of $56 058. Moreover, pH was reported in only 67% of patients. All patients treated with rFVIIa survived up to 4 hours after receiving this agent, while the 28-day mortality was 24% (8/33. Conclusion: The use of rFVIIa appears to be safe and effective in promoting hemostasis, as evident from reducing transfusion requirements and improving the coagulation variables.

Reduction of Turbidity of Water Using Locally Available Natural Coagulants

Science.gov (United States)

Asrafuzzaman, Md.; Fakhruddin, A. N. M.; Hossain, Md. Alamgir

2011-01-01

Turbidity imparts a great problem in water treatment. Moringa oleifera, Cicer arietinum, and Dolichos lablab were used as locally available natural coagulants in this study to reduce turbidity of synthetic water. The tests were carried out, using artificial turbid water with conventional jar test apparatus. Optimum mixing intensity and duration were determined. After dosing water-soluble extracts of Moringa oleifera, Cicer arietinum, and Dolichos lablab reduced turbidity to 5.9, 3.9, and 11.1 nephelometric turbidity unit (NTU), respectively, from 100 NTU and 5, 3.3, and 9.5, NTU, respectively, after dosing and filtration. Natural coagulants worked better with high, turbid, water compare to medium, or low, turbid, water. Highest turbidity reduction efficiency (95.89%) was found with Cicer arietinum. About 89 to 96% total coliform reduction were also found with natural coagulant treatment of turbid water. Using locally available natural coagulants, suitable, easier, and environment friendly options for water treatment were observed. PMID:23724307

Multiple roles of the coagulation protease cascade during virus infection.

Science.gov (United States)

Antoniak, Silvio; Mackman, Nigel

2014-04-24

The coagulation cascade is activated during viral infections. This response may be part of the host defense system to limit spread of the pathogen. However, excessive activation of the coagulation cascade can be deleterious. In fact, inhibition of the tissue factor/factor VIIa complex reduced mortality in a monkey model of Ebola hemorrhagic fever. Other studies showed that incorporation of tissue factor into the envelope of herpes simplex virus increases infection of endothelial cells and mice. Furthermore, binding of factor X to adenovirus serotype 5 enhances infection of hepatocytes but also increases the activation of the innate immune response to the virus. Coagulation proteases activate protease-activated receptors (PARs). Interestingly, we and others found that PAR1 and PAR2 modulate the immune response to viral infection. For instance, PAR1 positively regulates TLR3-dependent expression of the antiviral protein interferon β, whereas PAR2 negatively regulates expression during coxsackievirus group B infection. These studies indicate that the coagulation cascade plays multiple roles during viral infections.

Perioperative coagulation management and blood conservation in cardiac surgery: a Canadian Survey.

Science.gov (United States)

Taneja, Ravi; Fernandes, Philip; Marwaha, Gulshan; Cheng, Davy; Bainbridge, Daniel

2008-10-01

To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. Institutional survey. University hospital. All sites performing cardiac surgery in Canada. None. The response rate was 85%. Anticoagulation with heparin is monitored routinely through the activated coagulation time (ACT). Less than 10% of centers use heparin concentrations (Hepcon HMS, Medtronic), thromboelastography, or other point-of-care tests perioperatively. Eighty percent of centers routinely use tranexamic acid as the primary antifibrinolytic agent; however aprotinin until recently, was used more commonly for patients at increased risk for bleeding. Retrograde autologous prime is commonly used (62%); however, cell savers are uncommon for routine patients undergoing cardiac surgery (29%). Although most hospitals use a hematocrit of 20% to 21% for transfusing red blood cells, more than 50% of intensive care units do not have written guidelines for the administration of protamine, fresh frozen plasma, platelets, or factor VIIa. At least one third of centers do not audit their transfusion practices regularly. The majority of Canadian institutions do not use point-of-care tests other than ACT. Most institutions do not have algorithms for management of bleeding following cardiac surgery and at least 30% do not monitor their transfusion practice perioperatively. Cardiac surgery patients in Canada may benefit from a standardized approach to blood conservation in the perioperative period.

Coagulation Profile as a Risk Factor for 30-Day Morbidity and Mortality Following Posterior Lumbar Fusion.

Science.gov (United States)

Bronheim, Rachel S; Oermann, Eric K; Cho, Samuel K; Caridi, John M

2017-06-15

A retrospective cohort study. The aim of this study was to identify associations between abnormal coagulation profile and postoperative morbidity and mortality in patients undergoing posterior lumbar fusion (PLF). The literature suggests that abnormal coagulation profile is associated with postoperative complications, notably the need for blood transfusion. However, there is little research that directly addresses the influence of coagulation profile on postoperative complications following PLF. The American College of Surgeons National Surgical Quality Improvement Program database (ACS-NSQIP) was utilized to identify patients undergoing PLF between 2006 and 2013. Nine thousand two hundred ninety-five patients met inclusion criteria. Multivariate analysis was utilized to identify associations between abnormal coagulation profile and postoperative complications. Low platelet count was an independent risk factor for organ space surgical site infections (SSIs) [odds ratio (OR) = 6.0, P 48 hours (OR = 4.5, P = 0.002), Acute renal failure (OR = 5.8, P = 0.007), transfusion (OR = 1.6, P risk factor for ventilation >48 hours (OR = 5.6, P = 0.002), cerebrovascular accident (CVA)/stroke with neurological deficit (OR = 5.1, P = 0.011), cardiac arrest (OR = 5.4, P = 0.030), transfusion (OR = 1.5, P = 0.020), and death (OR = 4.5, P = 0.050). High International Normalized Ration (INR) was an independent risk factor for pneumonia (OR = 8.7, P = 0.001), pulmonary embolism (OR = 5.6, P = 0.021), deep venous thrombosis/Thrombophlebitis (OR = 4.8, P = 0.011), septic shock (OR = 8.4, P = 0.048), and death (OR = 9.8, P = 0.034). Bleeding disorder was an independent risk factor for organ space SSI (OR = 5.4, P = 0.01), pneumonia (OR = 3.0, P = 0.023), and sepsis (OR = 4.4, P profile was an independent predictor of morbidity and mortality in patients

Coagulation-flocculation studies of wastewaters

NARCIS (Netherlands)

Leentvaar, J.

1982-01-01

Although coagulation-flocculation processes have been practiced world-wide for almost a century in water treatment, several problems both in the theoretical and in the applied field have not been resolved yet. Especially interpretation of practical results with respect to governing

Cosmetic wastewater treatment by coagulation and advanced oxidation processes.

Science.gov (United States)

Naumczyk, Jeremi; Bogacki, Jan; Marcinowski, Piotr; Kowalik, Paweł

2014-01-01

In this study, the treatment process of three cosmetic wastewater types has been investigated. Coagulation allowed to achieve chemical oxygen demand (COD) removal of 74.6%, 37.7% and 74.0% for samples A (Al2(SO4)3), B (Brentafloc F3) and C (PAX 16), respectively. The Fenton process proved to be effective as well - COD removal was equal to 75.1%, 44.7% and 68.1%, respectively. Coagulation with FeCl3 and the subsequent photo-Fenton process resulted in the best values of final COD removal equal to 92.4%, 62.8% and 90.2%. In case of the Fenton process, after coagulation these values were equal to 74.9%, 50.1% and 84.8%, while in case of the H2O2/UV process, the obtained COD removal was 83.8%, 36.2% and 80.9%. High value of COD removal in the Fenton process carried out for A and C wastewater samples was caused by a significant contribution of the final neutralization/coagulation. Very small effect of the oxidation reaction in the Fenton process in case of sample A resulting from the presence of antioxidants, 'OH radical scavengers' in the wastewater.

Treatment of melanoidin wastewater by anaerobic digestion and coagulation.

Science.gov (United States)

Arimi, Milton M; Zhang, Yongjun; Götz, Gesine; Geißen, Sven-Uwe

2015-01-01

Melanoidins are dark-coloured recalcitrant pollutants found in many industrial wastewaters including coffee-manufacturing effluent, molasses distillery wastewater (MDWW) and other wastewater with molasses as the raw material. The wastewaters are mostly treated with anaerobic digestion after some dilution to minimize the inhibition effect. However, the dark colour and recalcitrant dissolved organic carbon (DOC) mainly caused by melanoidin are not effectively removed. The aim of this study was to investigate the removal of colour and remnant DOC by different coagulants from anaerobically digested MDWW. From the six coagulants tested, ferric chloride had the highest melanoidin (48%), colour (92.7%) and DOC (63.3%) removal at pH 5 and a dosage of 1.6 g/l. Both polymer and inorganic salt coagulants tested had optimal colour, melanoidin and DOC removal at acidic pH. The molecular size distribution of synthetic melanoidins by liquid chromatography-organic carbon detection indicated a preferential removal of high-molecular-weight melanoidins over low weight melanoidins by the coagulation. Further studies should focus on how to improve biodegradability of the treated effluent for it to be reused as dilution water for anaerobic digestion.

In vivo observation of the hypo-echoic "black hole" phenomenon in rat arterial bloodstream: a preliminary Study.

Science.gov (United States)

Nam, Kweon-Ho; Paeng, Dong-Guk

2014-07-01

The "black hole," a hypo-echoic hole at the center of the bloodstream surrounded by a hyper-echoic zone in cross-sectional views, has been observed in ultrasound backscattering measurements of blood with red blood cell aggregation in in vitro studies. We investigated whether the phenomenon occurs in the in vivo arterial bloodstream of rats using a high-frequency ultrasound imaging system. Longitudinal and cross-sectional ultrasound images of the rat common carotid artery (CCA) and abdominal aorta were obtained using a 40-MHz ultrasound system. A high-frame-rate retrospective imaging mode was employed to precisely examine the dynamic changes in blood echogenicity in the arteries. When the imaging was performed with non-invasive scanning, blood echogenicity was very low in the CCA as compared with the surrounding tissues, exhibiting no hypo-echoic zone at the center of the vessel. Invasive imaging of the CCA by incising the skin and subcutaneous tissues at the imaging area provided clearer and brighter blood echo images, showing the "black hole" phenomenon near the center of the vessel in longitudinal view. The "black hole" was also observed in the abdominal aorta under direct imaging after laparotomy. The aortic "black hole" was clearly observed in both longitudinal and cross-sectional views. Although the "black hole" was always observed near the center of the arteries during the diastolic phase, it dissipated or was off-center along with the asymmetric arterial wall dilation at systole. In conclusion, we report the first in vivo observation of the hypo-echoic "black hole" caused by the radial variation of red blood cell aggregation in arterial bloodstream. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

Removal of natural organic matter in drinking water treatment by coagulation: A comprehensive review.

Science.gov (United States)

Sillanpää, Mika; Ncibi, Mohamed Chaker; Matilainen, Anu; Vepsäläinen, Mikko

2018-01-01

Natural organic matter (NOM) is a complex matrix of organic substances produced in (or channeled to) aquatic ecosystems via various biological, geological and hydrological cycles. Such variability is posing a serious challenge to most water treatment technologies, especially the ones designed to treat drinking water supplies. Lately, in addition to the fluctuating composition of NOM, a substantial increase of its concentration in fresh waters, and also municipal wastewater effluents, has been reported worldwide, which justifies the urgent need to develop highly efficient and versatile water treatment processes. Coagulation is among the most applied processes for water and wastewater treatment. The application of coagulation to remove NOM from drinking water supplies has received a great deal of attention from researchers around the world because it was efficient and helped avoiding the formation of disinfection by products (DBPs). Nonetheless, with the increased fluctuation of NOM in water (concentration and composition), the efficiency of conventional coagulation was substantially reduced, hence the need to develop enhanced coagulation processes by optimizing the operating conditions (mainly the amount coagulants and pH), developing more efficient inorganic or organic coagulants, as well as coupling coagulation with other water treatment technologies. In the present review, recent research studies dealing with the application of coagulation for NOM removal from drinking water supplies are presented and compared. In addition, integration schemes combining coagulation and other water treatment processes are presented, including membrane filtration, oxidation, adsorption and others processes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Review of Coagulation Technology for Removal of Arsenic: Case of Chile

OpenAIRE

Sancha, Ana María

2006-01-01

Coagulation technology has been used since 1970 in northern Chile for removing arsenic from drinking-water. This experience suggests that coagulation is an effective technology for the removal of arsenic. It is currently possible to reduce arsenic from 400 μg/L to 10 μg/L at a rate of 500 L/sec, assuming pH, oxidizing and coagulation agents are strictly controlled. The Chilean experience with the removal of arsenic demonstrates that the water matrix dictates the selection of the arsenic-remov...

Coagulation-Adsorption Hybrid Process for the Treatment of Dyes and Pigments Wastewater

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Abdul Karim Shah

2013-10-01

Full Text Available The study aimed to improve the effectiveness of dyes and pigments wastewater treatment. Hybrid system of adsorption and coagulation was applied for the reduction of COD, color, turbidity and TSS. Activated carbon adsorbent was prepared from a waste of sugar industry boiler. It was processed through physicochemical treatment with sulfuric acid following grinding, sieving, washing and drying unit operations. Combined wastewater of dyes and pigments manufacturing plant was treated with a hybrid process of coagulation and adsorption. FeCl 3, FeSO 4and Alum coagulants were tested individually and found them less effective. It was revealed that FeCl 3 coagulation, adsorption and hybrid process reduced COD (41, 51 and 54%, Color (67, 70 and 89%, turbidity (69, 71 and 90% and TSS (82, 93 and 97% respectively. Combination of FeCl3 -SBFA (Sugarcane Bagasse Fly Ash proved 90% efficient in removal than coagulation as an individual process. 4g adsorbent dose was optimized for this hybrid process

Modelling of the Blood Coagulation Cascade in an In Vitro Flow System

DEFF Research Database (Denmark)

Andersen, Nina Marianne; Sørensen, Mads Peter; Efendiev, Messoud A.

2010-01-01

We derive a mathematical model of a part of the blood coagulation cascade set up in a perfusion experiment. Our purpose is to simulate the influence of blood flow and diffusion on the blood coagulation pathway. The resulting model consists of a system of partial differential equations taking...... and flow equations, which guarantee non negative concentrations at all times. The criteria is applied to the model of the blood coagulation cascade....

REMOVAL OF ORGANIC MATTER FROM SURFACE WATER USING COAGULANTS WITH VARIOUS BASICITY

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Lidia Dąbrowska

2016-07-01

Full Text Available Humic substances are a natural admixture of surface water and determine the level of organic pollution of water and colour intensity. Application of coagulation process in surface water treatment allows for decrease turbidity and colour of water, as well as organic matter content. In Poland most drinking water treatment plants use aluminium sulphate as a coagulant. Research works on pre-hydrolysed coagulants, e.g. polyaluminium chlorides (general formula Aln(OHmCl3n-m are also carried out. The aim of this study was to evaluate the effectiveness of the coagulation process using polyaluminium chlorides with different basicity, in reducing the level of pollution of surface water with organic substances. Apart from the typical indicators used to evaluate the content of organic compounds, the potential for trihalomethanes formation THM-FP was also determined. The influence of the type of coagulant (low, medium, highly alkaline on the efficiency of organic compound removal, determined as total organic carbon TOC, oxidisability OXI, absorbance UV254, was stated. Under the conditions of the coagulation (pH 7.2-7.4, temperature of 19-21°C, the best results were obtained using highly alkaline polyaluminium chlorides PAX-XL19F, PAX-XL1905 and PAX-XL1910S, decrease in TOC and OXI by 43-46%, slightly worse - 40-41% using low alkaline PAX18. Using the medium alkaline coagulants PAX-XL61 and PAXX-XL69, 30-35% removal of organic matter was obtained. Despite various effects of dissolved organic carbon removal, depending on the used coagulant, THM-FP in purified water did not differ significantly and ranged from 10.0 to 10.9 mgCHCl3 m-3. It was by 37-42% lower than in surface water.

New treatment strategies for disseminated intravascular coagulation based on current understanding of the pathophysiology

NARCIS (Netherlands)

Levi, Marcel; de Jonge, Evert; van der Poll, Tom

2004-01-01

A variety of clinical conditions may cause systemic activation of coagulation, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC). DIC consists of a widespread, systemic activation of coagulation, resulting in diffuse fibrin deposition in small and

The Interplay between Inflammation, Coagulation and Endothelial Injury in the Early Phase of Acute Pancreatitis: Clinical Implications

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Paulina Dumnicka

2017-02-01

Full Text Available Acute pancreatitis (AP is an inflammatory disease with varied severity, ranging from mild local inflammation to severe systemic involvement resulting in substantial mortality. Early pathologic events in AP, both local and systemic, are associated with vascular derangements, including endothelial activation and injury, dysregulation of vasomotor tone, increased vascular permeability, increased leukocyte migration to tissues, and activation of coagulation. The purpose of the review was to summarize current evidence regarding the interplay between inflammation, coagulation and endothelial dysfunction in the early phase of AP. Practical aspects were emphasized: (1 we summarized available data on diagnostic usefulness of the markers of endothelial dysfunction and activated coagulation in early prediction of severe AP; (2 we reviewed in detail the results of experimental studies and clinical trials targeting coagulation-inflammation interactions in severe AP. Among laboratory tests, d-dimer and angiopoietin-2 measurements seem the most useful in early prediction of severe AP. Although most clinical trials evaluating anticoagulants in treatment of severe AP did not show benefits, they also did not show significantly increased bleeding risk. Promising results of human trials were published for low molecular weight heparin treatment. Several anticoagulants that proved beneficial in animal experiments are thus worth testing in patients.

Neural signature of coma revealed by posteromedial cortex connection density analysis

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Briguita Malagurski

2017-01-01

A complex pattern of decreased and increased connections was observed, suggesting a network imbalance between internal/external processing systems, within PMC during coma. The number of PMC voxels with hypo-CD positive correlation showed a significant negative association with the CRS-R score, notwithstanding aetiology. Traumatic injury specifically appeared to be associated with a greater prevalence of hyper-connected (negative correlation voxels, which was inversely associated with patient neurological outcome. A logistic regression model using the number of hypo-CD positive and hyper-CD negative correlations, accurately permitted patient's outcome prediction (AUC = 0.906, 95%IC = 0.795–1. These points might reflect adaptive plasticity mechanism and pave the way for innovative prognosis and therapeutics methods.

Removal of total suspended solid by natural coagulant derived from cassava peel waste

Science.gov (United States)

Mohd-Asharuddin, S.; Othman, N.; Mohd-Zin, N. S.; Tajarudin, H. A.

2018-04-01

The present study was aimed to investigate the performance of starch derived from cassava peel waste as primary coagulant and coagulant aid. Comparable study was also conducted using commercially used aluminium sulfate (alum) as primary coagulant. A series of Jar tests were performed using raw water from Sembrong Barat water treatment plant. It was observed that coagulation test using cassava peel starch (CPS) alone had unappreciable removing ability. However, it was found that combination of alum-CPS successfully achieve up to 90.48% of total suspended solid (TSS) removal under optimized working conditions (pH 9, 7.5mg/L : 100 mg/L of alum : CPS dosage, rapid mixing of 200 rpm for 1 minute; 100 rpm for 2 minutes, slow mixing of 25 rpm for 30 minutes and 30 minutes settling time). This remarks the reduction in alum dosage up to 50% compared to coagulation test using alum alone. Therefore this finding suggesting that CPS can be considered as potential source of sustainable and effective coagulant aid for water treatment especially in developing countries.

Causes and consequences of coagulation activation in sepsis: an evolutionary medicine perspective.

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Fiusa, Maiara Marx Luz; Carvalho-Filho, Marco Antonio; Annichino-Bizzacchi, Joyce M; De Paula, Erich V

2015-05-06

Coagulation and innate immunity have been linked together for at least 450 million years of evolution. Sepsis, one of the world's leading causes of death, is probably the condition in which this evolutionary link is more evident. However, the biological and the clinical relevance of this association have only recently gained the attention of the scientific community. During sepsis, the host response to a pathogen is invariably associated with coagulation activation. For several years, coagulation activation has been solely regarded as a mechanism of tissue damage, a concept that led to several clinical trials of anticoagulant agents for sepsis. More recently, this paradigm has been challenged by the failure of these clinical trials, and by a growing bulk of evidence supporting the concept that coagulation activation is beneficial for pathogen clearance. In this article we discuss recent basic and clinical data that point to a more balanced view of the detrimental and beneficial consequences of coagulation activation in sepsis. Reappraisal of the association between coagulation and immune activation from an evolutionary medicine perspective offers a unique opportunity to gain new insights about the pathogenesis of sepsis, paving the way to more successful approaches in both basic and clinical research in this field.

Pretreatment of wastewater: Optimal coagulant selection using Partial Order Scaling Analysis (POSA)

International Nuclear Information System (INIS)

Tzfati, Eran; Sein, Maya; Rubinov, Angelika; Raveh, Adi; Bick, Amos

2011-01-01

Jar-test is a well-known tool for chemical selection for physical-chemical wastewater treatment. Jar test results show the treatment efficiency in terms of suspended matter and organic matter removal. However, in spite of having all these results, coagulant selection is not an easy task because one coagulant can remove efficiently the suspended solids but at the same time increase the conductivity. This makes the final selection of coagulants very dependent on the relative importance assigned to each measured parameter. In this paper, the use of Partial Order Scaling Analysis (POSA) and multi-criteria decision analysis is proposed to help the selection of the coagulant and its concentration in a sequencing batch reactor (SBR). Therefore, starting from the parameters fixed by the jar-test results, these techniques will allow to weight these parameters, according to the judgments of wastewater experts, and to establish priorities among coagulants. An evaluation of two commonly used coagulation/flocculation aids (Alum and Ferric Chloride) was conducted and based on jar tests and POSA model, Ferric Chloride (100 ppm) was the best choice. The results obtained show that POSA and multi-criteria techniques are useful tools to select the optimal chemicals for the physical-technical treatment.

Multipurpose HTS Coagulation Analysis: Assay Development and Assessment of Coagulopathic Snake Venoms

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Kristina B. M. Still

2017-11-01

Full Text Available Coagulation assays currently employed are often low throughput, require specialized equipment and/or require large blood/plasma samples. This study describes the development, optimization and early application of a generic low-volume and high-throughput screening (HTS assay for coagulation activity. The assay is a time-course spectrophotometric measurement which kinetically measures the clotting profile of bovine or human plasma incubated with Ca2+ and a test compound. The HTS assay can be a valuable new tool for coagulation diagnostics in hospitals, for research in coagulation disorders, for drug discovery and for venom research. A major effect following envenomation by many venomous snakes is perturbation of blood coagulation caused by haemotoxic compounds present in the venom. These compounds, such as anticoagulants, are potential leads in drug discovery for cardiovascular diseases. The assay was implemented in an integrated analytical approach consisting of reversed-phase liquid chromatography (LC for separation of crude venom components in combination with parallel post-column coagulation screening and mass spectrometry (MS. The approach was applied for the rapid assessment and identification of profiles of haemotoxic compounds in snake venoms. Procoagulant and anticoagulant activities were correlated with accurate masses from the parallel MS measurements, facilitating the detection of peptides showing strong anticoagulant activity.

Arsenic removal by coagulation using ferric chloride and chitosan from water

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Farid Hesami

2013-01-01

Conclusions: Chitosan as natural coagulant aid improved arsenic removal efficiency by coagulation process using FeCl 3 . This method can be used for regions with drinking water contaminated with initial arsenic concentration less than 1 000 μg/l.

COAGULATION PROFILE IN DIABETES MELLITUS AND ITS ASSOCIATION WITH MICROVASCULAR COMPLICATIONS

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Uma Shankar Mishra

2017-12-01

Full Text Available BACKGROUND This study intends to assess the changes in the simple routine coagulation parameters in diabetes mellitus and to investigate whether any relationship exists among changes in these coagulation parameters and development of microvascular complication in diabetes mellitus. MATERIALS AND METHODS Period of study was from 2010-2012. It was done in M.K.C.G. Medical College with the approval from Berhampur University. It is a case control study. 50 diabetic patients and 50 age and sex matched non-diabetic patients were randomly selected. Simple coagulation parameters like Activated Partial Thromboplastin Time (aPTT, Prothrombin Time (PT, serum fibrinogen, platelet count and Plasminogen Activator Inhibitor-1 (PAI-1 were measured. Statistical study was done using unpaired t-test and analysis and calculations were done using GraphPad software. RESULTS Serum fibrinogen was found to be increased in diabetic patients when compared to non-diabetic patients (mean 278 ± 26.9 v/s 232.52 ± 16.5, P value - 0.009, significant. PAI-1 levels was found to be higher among the diabetics when compared to nondiabetics (47.64 ± 8.82 v/s 31.06 ± 7.12, the two-tailed P value is <0.0001, considered extremely significant. Platelet count through within normal limits. It was found to be decreased in diabetic patient when compared to non-diabetic (2.25 ± 0.18 v/s 2.33 ± 0.03, P value - 0.022. Prothrombin Time (PT (13.15 ± 0.52 v/s 13.04 ± 0.49, P value - 0.28 and PTT (33.04 ± 1.31 v/s 32.99 ± 1.29, P value 0.85, found to be statistically insignificant. Among 50 diabetic patients, 24 had neuropathy, 20 had nephropathy, 10 had retinopathy and 21 had none of these complications. On comparing diabetic patients with microvascular complications and without microvascular complications, significant age difference was observed (59.55 ± 5.06 v/s 51.00 ± 3.31, P=0.003. This probably was a reflection of increase in microvascular complications with increasing duration

Effect of liberal blood transfusion on clinical outcomes and cost in spine surgery patients.

Science.gov (United States)

Purvis, Taylor E; Goodwin, C Rory; De la Garza-Ramos, Rafael; Ahmed, A Karim; Lafage, Virginie; Neuman, Brian J; Passias, Peter G; Kebaish, Khaled M; Frank, Steven M; Sciubba, Daniel M

2017-09-01

Blood transfusions in spine surgery are shown to be associated with increased patient morbidity. The association between transfusion performed using a liberal hemoglobin (Hb) trigger-defined as an intraoperative Hb level of ≥10 g/dL, a postoperative level of ≥8 g/dL, or a whole hospital nadir between 8 and 10 g/dL-and perioperative morbidity and cost in spine surgery patients is unknown and thus was investigated in this study. This study aimed to describe the perioperative outcomes and economic cost associated with liberal Hb trigger transfusion among spine surgery patients. This is a retrospective study. The surgical billing database at our institution was queried for inpatients discharged between 2008 and 2015 after the following procedures: atlantoaxial fusion, anterior cervical fusion, posterior cervical fusion, anterior lumbar fusion, posterior lumbar fusion, lateral lumbar fusion, other procedures, and tumor-related surgeries. In total, 6,931 patients were included for analysis. The primary outcome was composite morbidity, which was composed of (1) infection (sepsis, surgical-site infection, Clostridium difficile infection, or drug-resistant infection); (2) thrombotic event (pulmonary embolus, deep venous thrombosis, or disseminated intravascular coagulation); (3) kidney injury; (4) respiratory event; and (5) ischemic event (transient ischemic attack, myocardial infarction, or cerebrovascular accident). Data on intraoperative transfusion were obtained from an automated, prospectively collected anesthesia data management system. Data on postoperative hospital transfusion were obtained through a Web-based intelligence portal. Based on previous research, we analyzed the data using three definitions of a liberal transfusion trigger in patients who underwent red blood cell transfusion: a liberal intraoperative Hb trigger as a nadir Hb level of 10 g/dL or greater, a liberal postoperative Hb trigger as a nadir Hb level of 8 g/dL or greater, or a whole

Both Hypo-Connectivity and Hyper-Connectivity of the Insular Subregions Associated With Severity in Children With Autism Spectrum Disorders

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Jinping Xu

2018-04-01

Full Text Available Some studies identified hypo-connectivity, while others showed hyper-connectivity of the insula in the autism spectrum disorders (ASD. These contradictory findings leave open the question of whether and to what extent functional connectivity of the insula is altered and how functional connectivity of the insula is associated with the severity of ASD. A newly emerging insular atlas that comprises multiple functionally differentiated subregions provides a new framework to interpret the functional significance of insular findings and uncover the mechanisms underlying the severity of ASD. Using the new insular atlas, the present study aimed to investigate the distinct functional connectivity of the insular subregions and their associations with ASD severity in a cohort of 49 children with ASD and 33 typically developing (TD subjects. We found that compared with TD group, the ASD group showed different connectivity patterns in the left ventral agranular insula, right ventral dysgranular and granular insula, and dorsal dysgranular insula, characterized by significant hyper-connectivity and/or hypo-connectivity with special brain regions. Furthermore, both the hypo-connectivity and hyper-connectivity patterns of the insular subregions were significantly associated with the severity of ASD symptoms. Our research demonstrated distinct functional connectivity patterns of the insular subregions and emphasized the importance of the subdivisions within the insula to the potential impact of functional difference in children with ASD. Moreover, these results might help us to better understand the mechanisms underlying the symptoms in children with ASD and might elucidate potential biomarkers for clinical applications.

Evaluation of Moringa oleifera seed as coagulation aid for treatment ...

African Journals Online (AJOL)

Laboratory tests were carried out to evaluate the potentials of Moringa oleifera seed powder as a coagulation aid for removal of suspended particles in fish culture effluent. The standard jar test was used to investigate the dosage and mixing intensity required to optimize the use of the coagulant in removing of suspended ...

Prospective validation of the International Society of Thrombosis and Haemostasis scoring system for disseminated intravascular coagulation

NARCIS (Netherlands)

Bakhtiari, Kamran; Meijers, Joost C. M.; de Jonge, Evert; Levi, Marcel

2004-01-01

Objectives: A diagnosis of disseminated intravascular coagulation (DIC) is hampered by the lack of an accurate diagnostic test. Based on the retrospective analysis of studies in patients with DIC, a scoring system (0-8 points) using simple and readily available routine laboratory tests has been

Authentic leadership and nurse-assessed adverse patient outcomes.

Science.gov (United States)

Wong, Carol A; Giallonardo, Lisa M

2013-07-01

Our purpose was to test a model examining relationships among authentic leadership, nurses' trust in their manager, areas of work life and nurse-assessed adverse patient outcomes. Although several work environment factors have been cited as critical to patient outcomes, studies linking nursing leadership styles with patient outcomes are limited suggesting the need for additional research to investigate the mechanisms by which leadership may influence patient outcomes. Secondary analysis of data collected in a cross-sectional survey of 280 (48% response rate) registered nurses working in acute care hospitals in Ontario was conducted using structural equation modelling. The final model fit the data acceptably (χ(2) = 1.30, df = 2, P = 0.52, IFI = 0.99, CFI = 1.00, RMSEA = 0.00). Authentic leadership was significantly associated with decreased adverse patient outcomes through trust in the manager and areas of work life. The findings suggest that nurses who see their managers as demonstrating high levels of authentic leadership report increased trust, greater congruence in the areas of work life and lower frequencies of adverse patient outcomes. Managers who emphasize transparency, balanced processing, self-awareness and high ethical standards in their interactions with nurses may contribute to safer work environments for patients and nurses. © 2013 John Wiley & Sons Ltd.

Coagulation of sheep intestinal and prefemoral lymph.

Science.gov (United States)

Hanley, C A; Johnston, M G; Nelson, W

1988-06-01

We have determined the most suitable method for the automated analysis of the clotting parameters in sheep intestinal and prefemoral lymph as defined by the Activated Partial Thromboplastin Times (APTT; measure of intrinsic coagulation pathway) and the Prothrombin Times (PT; measure of extrinsic coagulation pathway). As opposed to optical density systems, the use of a Fibro-System Fibrometer was found to provide the most consistent assessment of coagulation with the endpoint being the time to fibrin strand formation. We measured APTT in sheep intestinal and prefemoral lymph of 59.78 +/- 7.69 seconds and 51.03 +/- 10.49 seconds respectively. These values were more prolonged than those obtained from sheep blood plasma but only in the case of intestinal lymph were the differences significant (p less than 0.025). Human blood APTT values were significantly less than both sheep blood (p less than 0.05) and sheep intestinal (p less than 0.001) and prefemoral lymph (p less than 0.01). PT values were found to be 21.56 +/- 1.14 seconds in intestinal and 22.00 +/- 1.88 seconds in prefemoral lymph. These values were also significantly greater than those obtained from sheep blood (both p less than 0.001). Human blood PTs were significantly less than both sheep blood (p less than 0.001) and intestinal and prefemoral lymph (both p less than 0.001). Measurement of APTT and PT values in intestinal lymph and PT determinations in prefemoral lymph were not affected by storage in the refrigerator or freezer. There was some indication that APTT values in prefemoral samples were susceptible to storage artifacts; however, the differences in coagulation times were not significant.

Low-cost multi-stage filtration enhanced by coagulation-flocculation in upflow gravel filtration

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L. D. Sánchez

2012-12-01

Full Text Available This paper assesses the operational and design aspects of coagulation and flocculation in upflow gravel filters (CF-UGF in a multi-stage filtration (MSF plant. This study shows that CF-UGF units improve the performance of MSF considerably, when the system operates with turbidity above 30 NTU. It strongly reduces the load of particulate material before the water enters in the slow sand filters (SSF and therewith avoids short filter runs and prevents early interruption in SSF operations. The removal efficiency of turbidity in the CF-UGF with coagulant was between 85 and 96%, whereas the average efficiency without coagulant dosing was 46% (range: 21–76%. Operating with coagulant also improves the removal efficiency for total coliforms, E-coli and HPC. No reduction was observed in the microbial activity of the SSF, no obstruction of the SSF bed was demonstrated and SSF runs were maintained between 50 and 70 days for a maximum head loss of 0.70 m. The most important advantage is the flexibility of the system to operate with and without coagulant according to the influent turbidity. It was only necessary for 20% of the time to operate with the coagulant. The CF-UGF unit represented 7% of total construction costs and the O&M cost for the use of coagulant represented only 0.3%.

Performance optimization of coagulant/flocculant in the treatment of wastewater from a beverage industry.

Science.gov (United States)

Amuda, O S; Amoo, I A; Ajayi, O O

2006-02-28

This study investigated the effect of coagulation/flocculation treatment process on wastewater of Fumman Beverage Industry, Ibadan, Nigeria. The study also compared different dosages of coagulant, polyelectrolyte (non-ionic polyacrylamide) and different pH values of the coagulation processes. The effect of different dosages of polyelectrolyte in combination with coagulant was also studied. The results reveal that low pH values (3-8), enhance removal efficiency of the contaminants. Percentage removal of 78, 74 and 75 of COD, TSS and TP, respectively, were achieved by the addition of 500 mg/L Fe2(SO4)3.3H2O and 93, 94 and 96% removal of COD, TSS and TP, respectively, were achieved with the addition of 25 mg/L polyelectrolyte to the coagulation process. The volume of sludge produced, when coagulant was used solely, was higher compared to the use of polyelectrolyte combined with Fe2(SO4)3.3H2O. This may be as a result of non-ionic nature of the polyelectrolyte; hence, it does not chemically react with solids of the wastewater. Coagulation/flocculation may be useful as a pre-treatment process for beverage industrial wastewater prior to biological treatment.

Early predictors of health-related quality of life outcomes in polytrauma patients with spine injuries: a level 1 trauma center study.

Science.gov (United States)

Tee, J W; Chan, C H P; Gruen, R L; Fitzgerald, M C B; Liew, S M; Cameron, P A; Rosenfeld, J V

2014-02-01

Study Design Retrospective review on clinical-quality trauma registry prospective data. Objective To identify early predictors of suboptimal health status in polytrauma patients with spine injuries. Methods A retrospective review on a prospective cohort was performed on spine-injured polytrauma patients with successful discharge from May 2009 to January 2011. The Short Form 12-Questionnaire Health Survey (SF-12) was used in the health status assessment of these patients. Univariate and multivariate logistic regression models were applied to investigate the effects of the Injury Severity Score, age, blood sugar level, vital signs, brain trauma severity, comorbidities, coagulation profile, spine trauma-related neurologic status, and spine injury characteristics of the patients. Results The SF-12 had a 52.3% completion rate from 915 patients. The patients who completed the SF-12 were younger, and there were fewer patients with severe spinal cord injuries (American Spinal Injury Association classifications A, B, and C). Other comparison parameters were satisfactorily matched. Multivariate logistic regression revealed five early predictive factors with statistical significance (p ≤ 0.05). They were (1) tachycardia (odds ratio [OR] = 1.88; confidence interval [CI] = 1.11 to 3.19), (2) hyperglycemia (OR = 2.65; CI = 1.51 to 4.65), (3) multiple chronic comorbidities (OR = 2.98; CI = 1.68 to 5.26), and (4) thoracic spine injuries (OR = 1.54; CI = 1.01 to 2.37). There were no independent early predictive factors identified for suboptimal mental health-related qualify of life outcomes. Conclusion Early independent risk factors predictive of suboptimal physical health status identified in a level 1 trauma center in polytrauma patients with spine injuries were tachycardia, hyperglycemia, multiple chronic medical comorbidities, and thoracic spine injuries. Early spine trauma risk factors were shown not to predict suboptimal mental

Ictal brain SPET during seizures pharmacologically provoked with pentylenetetrazol: a new diagnostic procedure in drug-resistant epileptic patients

International Nuclear Information System (INIS)

Calcagni, Maria Lucia; Giordano, Alessandro; Bruno, Isabella; Di Giuda, Daniela; De Rossi, Giuseppe; Troncone, Luigi; Parbonetti, Giovanni; Colicchio, Gabriella

2002-01-01

Functional brain imaging plays an important role in seizure focus localisation. However, truly ictal single-photon emission tomography (SPET) studies are not routinely performed owing to technical problems associated with the use of tracers and methodological and logistical difficulties. In this study we tried to resolve both of these issues by means of a new procedure: technetium-99m ethyl cysteinate dimer (ECD) brain SPET performed during seizures pharmacologically provoked with pentylenetetrazol, a well-known central and respiratory stimulant. We studied 33 drug-resistant epileptic patients. All patients underwent anamnestic evaluation, neuropsychological and psychodynamic assessment, magnetic resonance imaging, interictal and ictal video-EEG monitoring, and interictal and ictal SPET with 99m Tc-ECD. In order to obtain truly ictal SPET, 65 mg of pentylenetetrazol was injected every 2 minutes and, immediately the seizure began, 740 MBq of 99m Tc-ECD was injected. The scintigraphic findings were considered abnormal if a single area of hyperperfusion was present and corresponded to the site of a single area of hypoperfusion at interictal SPET: the ''hypo-hyperperfusion'' SPET pattern. In 27 of the 33 patients (82%), interictal-ictal SPET showed the hypo-hyperperfusion SPET pattern. Video-EEG showed a single epileptogenic zone in 21/33 patients (64%), and MRI showed anatomical lesions in 19/33 patients (57%). Twenty-two of the 27 patients with hypo-hyperperfusion SPET pattern underwent ablative or palliative surgery and were seizure-free at 3 years of follow-up. No adverse effects were noted during pharmacologically provoked seizure. It is concluded that ictal brain SPET performed during pharmacologically provoked seizure provides truly ictal images because 99m Tc-ECD is injected immediately upon seizure onset. Using this feasible procedure it is possible to localise the focus, to avoid the limitations due to the unpredictability of seizures, to avoid pitfalls due

Inhibitory Effect of Triterpenoids from Panax ginseng on Coagulation Factor X

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Lingxin Xiong

2017-04-01

Full Text Available Enzymes involved in the coagulation process have received great attention as potential targets for the development of oral anti-coagulants. Among these enzymes, coagulation factor Xa (FXa has remained the center of attention in the last decade. In this study, 16 ginsenosides and two sapogenins were isolated, identified and quantified. To determine the inhibitory potential on FXa, the chromogenic substrates method was used. The assay suggested that compounds 5, 13 and 18 were mainly responsible for the anti-coagulant effect. Furthermore, these three compounds also possessed high thrombin selectivity in the thrombin inhibition assay. Furthermore, Glide XP from Schrödinger was employed for molecular docking to clarify the interaction between the bioactive compounds and FXa. Therefore, the chemical and biological results indicate that compounds 5 (ginsenoside Rg2, 13 (ginsenoside Rg3 and 18 (protopanaxtriol, PPT are potential natural inhibitors against FXa.

Interpretation of coagulation test results using a web-based reporting system.

Science.gov (United States)

Quesada, Andres E; Jabcuga, Christine E; Nguyen, Alex; Wahed, Amer; Nedelcu, Elena; Nguyen, Andy N D

2014-01-01

Web-based synoptic reporting has been successfully integrated into diverse fields of pathology, improving efficiency and reducing typographic errors. Coagulation is a challenging field for practicing pathologists and pathologists-in-training alike. To develop a Web-based program that can expedite the generation of a individualized interpretive report for a variety of coagulation tests. We developed a Web-based synoptic reporting system composed of 119 coagulation report templates and 38 thromboelastography (TEG) report templates covering a wide range of findings. Our institution implemented this reporting system in July 2011; it is currently used by pathology residents and attending pathologists. Feedback from the users of these reports have been overwhelmingly positive. Surveys note the time saved and reduced errors. Our easily accessible, user-friendly, Web-based synoptic reporting system for coagulation is a valuable asset to our laboratory services. Copyright© by the American Society for Clinical Pathology (ASCP).

Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.

Science.gov (United States)

Hunter, Robert; Cameron, Rosie; Norrie, John

2009-02-01

The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine

Natural coagulation inhibitors and active protein c resistance in preeclampsia

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Cengiz Demir

2010-01-01

Full Text Available INTRODUCTION: The etiology of preeclampsia is not fully established. A few studies have shown a relationship between natural coagulation inhibitors and preeclampsia. OBJECTIVES: The purpose of this study was to investigate the status of natural coagulation inhibitors and active protein C resistance (APC-R in preeclampsia. PATIENTS AND METHODS: We studied 70 women with preeclampsia recruited consecutively and 70 healthy pregnant and 70 nonpregnant women as controls. Plasma protein C (PC, free protein S (fPS, antithrombin III (ATIII and APC-R were evaluated. RESULTS: ATIII values were found to be significantly lower in preeclamptic patients than in the control groups (p< 0.001. Nevertheless, there was no significant difference between the healthy pregnant and nonpregnant women groups (p=0.141. The fPS values of the preeclamptic and healthy pregnant groups were lower than that of the nonpregnant group (p< 0.001, and the fPS value of the preeclamptic pregnant women was lower than that of healthy pregnant women (p<0.001. The PC value of the preeclamptic pregnant women was lower than that of the control groups (p< 0.001. The PC value of the healthy pregnant women was lower than that of the nonpregnant women (p< 0.001. The mean APC activity values were lower in the preeclamptic patients than that of the control groups (p< 0.001, p< 0.001. The APC-R positivity rates of the preeclamptic groups were higher than that of the control groups (p<0.001. CONCLUSIONS: This study demonstrated that ATIII, fPS, PC values and APC resistance were lower and APC-R positivity was higher in preeclamptic women than in normal pregnant and nonpregnant women.

Proceedings of Patient Reported Outcome Measure’s (PROMs Conference Sheffield 2016: advances in patient reported outcomes research

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Tim Croudace

2016-10-01

Full Text Available Table of contents S1 Using computerized adaptive testing Tim Croudace S2 Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policy John Brazier O1 “Am I going to get better?”—Using PROMs to inform patients about the likely benefit of surgery Nils Gutacker, Andrew Street O2 Identifying Patient Reported Outcome Measures for an electronic Personal Health Record Dan Robotham, Samantha Waterman, Diana Rose, Safarina Satkunanathan, Til Wykes O3 Examining the change process over time qualitatively: transformative learning and response shift Nasrin Nasr, Pamela Enderby O4 Developing a PROM to evaluate self-management in diabetes (HASMID: giving patients a voice Jill Carlton, Donna Rowen, Jackie Elliott, John Brazier, Katherine Stevens, Hasan Basarir, Alex Labeit O5 Development of the Primary Care Outcomes Questionnaire (PCOQ Mairead Murphy, Sandra Hollinghurst, Chris Salisbury O6 Developing the PKEX score- a multimodal assessment tool for patients with shoulder problems Dominic Marley, James Wilson, Amy Barrat, Bibhas Roy O7 Applying multiple imputation to multi-item patient reported outcome measures: advantages and disadvantages of imputing at the item, sub-scale or score level Ines Rombach, Órlaith Burke, Crispin Jenkinson, Alastair Gray, Oliver Rivero-Arias O8 Integrating Patient Reported Outcome Measures (PROMs into routine primary care for patients with multimorbidity: a feasibility study Ian Porter, Jaheeda Gangannagaripalli, Charlotte Bramwell, Jose M. Valderas O9 eRAPID: electronic self-report and management of adverse-events for pelvic radiotherapy (RT patients Patricia Holch, Susan Davidson, Jacki Routledge, Ann Henry, Kevin Franks, Alex Gilbert, Kate Absolom & Galina Velikova O10 Patient reported outcomes (PROMs based recommendation in clinical guidance for the management of chronic conditions in the United Kingdom Ian Porter, Jose M.Valderas O11 Cross-sectional and

Photoacoustic discrimination of viable and thermally coagulated blood using a two-wavelength method for burn injury monitoring

International Nuclear Information System (INIS)

Talbert, Robert J; Holan, Scott H; Viator, John A

2007-01-01

Discriminating viable from thermally coagulated blood in a burn wound can be used to profile burn depth, thus aiding the removal of necrotic tissue. In this study, we used a two-wavelength photoacoustic imaging method to discriminate coagulated and non-coagulated blood in a dermal burn phantom. Differences in the optical absorption spectra of coagulated and non-coagulated blood produce different values of the ratio of peak photoacoustic amplitude at 543 and 633 nm. The absorption values obtained from spectroscopic measurements indicate that the ratio of photoacoustic pressure for 543 and 633 nm for non-coagulated blood was 15.7:1 and 1.6:1 for coagulated blood. Using planar blood layers, we found the photoacoustic ratios to be 13.5:1 and 1.6:1, respectively. Using the differences in the ratios of coagulated and non-coagulated blood, we propose a scheme using statistical classification analysis to identify the different blood samples. Based upon these distinctly different ratios, we identified the planar blood samples with an error rate of 0%. Using a burn phantom with cylindrical vessels containing coagulated and non-coagulated blood, we achieved an error rate of 11.4%. These results have shown that photoacoustic imaging could prove to be a valuable tool in the diagnosis of burns

Comparison of the level of residual coagulant activity in different cheese varieties.

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Bansal, Nidhi; Fox, Patrick F; McSweeney, Paul L H

2009-08-01

The coagulant retained in cheese curd is a major contributor to proteolysis during ripening. The objective of this study was to quantify residual coagulant in 9 cheese varieties by measuring its activity on a synthetic heptapeptide (Pro-Thr-Glu-Phe-[NO2-Phe]-Arg-Leu) assayed using reversed-phase HPLC. The level of residual coagulant activity was highest in Camembert cheese, probably due to its low pH at whey drainage and the high moisture content of the cheese, followed in order by Feta=Port du Salut=Cheddar>Gouda>Emmental=Parmigiano Reggiano=low-moisture part-skim Mozzarella=Mozzarella di Bufala Campana. The high cooking temperature (50-54 degrees C) used during the manufacture of Emmental and Parmigiano Reggiano cheeses and the cooking and stretching step in hot water during the manufacture of Mozzarella cheese may be the reasons for the lowest residual coagulant activity in these cheeses. The level of residual coagulant activity was higher in Feta cheese made from milk concentrated by ultrafiltration than in conventional Feta.

Radiotherapy in stage 3, unresectable, asymptomatic non-small cell lung cancer. Final results of a prospective randomized study of 240 patients

International Nuclear Information System (INIS)

Reinfuss, M.; Glinski, B.; Kowalska, T.; Kulpa, J.; Zawila, K.; Reinfuss, K.; Dymek, P.; Herman, K.; Skolyszewski, J.

1999-01-01

Purpose: to report the results of a prospective randomized study concerning the role of radiotherapy in the treatment of stage III, unresectable, asymptomatic non-small cell lung cancer. Material and methods: between 1992 and 1996, 240 patients with stage III, unresectable, asymptomatic non-small cell lung cancer were enrolled in this study, and sequentially randomized to one of the three treatment arms: conventional irradiation, hypo-fractionated irradiation and control group. In the conventional irradiation arm (79 patients), a dose of 50 Gy in 25 fractions in five weeks was delivered to the primary tumor and the mediastinum. In the hypo-fractionated irradiation arm (81 patients), there were two courses of irradiation separated by an interval of four weeks. In each series, patients received 20 Gy in five fractions in five days, in the same treatment volume as the conventional irradiation group. in the control group arm, 80 patients initially did not receive radiotherapy and were only observed. Delayed palliative hypo-fractionated irradiation (20-25 Gy in four to five fractions in four to five days) was given to the primary tumor when major symptoms developed. Results: the two-year actuarial survival rates for patients in the conventional irradiation, hypo-fractionated irradiation and control group arms were 18%, 6% and 0%, with a median survival time of 12 months, nine months and six months respectively. The differences between survival rates were statistically significant at the 0.05 level. Conclusion: although irradiation provides good palliation the results are disappointing. The comparison of conventional and hypo-fractionated irradiation shows an advantage for conventional schedules. (author)

Characteristics of BPA removal from water by PACl-Al13 in coagulation process.

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Xiaoying, Ma; Guangming, Zeng; Chang, Zhang; Zisong, Wang; Jian, Yu; Jianbing, Li; Guohe, Huang; Hongliang, Liu

2009-09-15

This paper discussed the coagulation characteristics of BPA with polyaluminum chloride (PACl-Al(13)) as coagulant, examined the impact of coagulation pH, PACl-Al(13) dosage, TOC (total organic carbon) and turbidity on BPA removal, and analyzed the possible dominant mechanisms in water coagulation process. Formation and performance of flocs during coagulation processes were monitored using photometric dispersion analyzer (PDA). When the concentration of humic acid matters and turbidity was low in the solution, the experimental results showed that the removal of BPA experienced increase and subsequently decrease with the PACl-Al(13) dosage increasing. The optimal PACl-Al(13) dosage was found at BPA/PACl-Al(13)=1:2.6(M/M) under our experiment conditions. Results show that the maximum BPA removal efficiency occurred at pH 9.0 due to the adsorption by Al(13) aggregates onto BPA rather than charge neutralization mechanism by polynuclear aluminous salts in the solution. The humic acid matters and kaolin in the solution have significant effect on BPA removal with PACl-Al(13) in the coagulation. The BPA removal will be weakened at high humic matters. The removal rate of BPA increased and subsequently decreased with the turbidity increasing.

Effects of storage conditions of Moringa oleifera seeds on its performance in coagulation.

Science.gov (United States)

Katayon, S; Noor, M J Megat Mohd; Asma, M; Ghani, L A Abdul; Thamer, A M; Azni, I; Ahmad, J; Khor, B C; Suleyman, A M

2006-09-01

Moringa oleifera is a plant whose seeds have coagulation properties for treating water and wastewater. In this study the coagulation efficiency of Moringa oleifera kept in different storage conditions were studied. The Moringa oleifera seeds were stored at different conditions and durations; open container and closed container at room temperature (28 degrees C) and refrigerator (3 degrees C) for durations of 1, 3 and 5 months. Comparison between turbidity removal efficiency of Moringa oleifera kept in refrigerator and room temperature revealed that there was no significant difference between them. The Moringa oleifera kept in refrigerator and room temperature for one month showed higher turbidity removal efficiency, compared to those kept for 3 and 5 months, at both containers. The coagulation efficiency of Moringa oleifera was found to be dependent on initial turbidity of water samples. Highest turbidity removals were obtained for water with very high initial turbidity. In summary coagulation efficiency of Moringa oleifera was found independent of storage temperature and container, however coagulation efficiency of Moringa oleifera decreased as storage duration increased. In addition, Moringa oleifera can be used as a potential coagulant especially for very high turbidity water.

Application of Moringa Oleifera Seed Powder for Iron (III) Coagulation on Local Water Resources

OpenAIRE

Prasetyaningtyas, Fadillah Utami; Rumhayati, Barlah; Masruri, Masruri

2013-01-01

This research aims to know the effect of the use of powder moringa seed to coagulant mass and coagulation process, and its effectiveness to increase the quality of pure water. This research uses factorial research design and statistic test MANOVA. To analyse water quality, the researcher uses Fe parameter.  A graphic of coagulant mass and time for each parameter is used to analyse the data. Based on the research result, the uses of moringa seed as coagulant in each 300 mL mineral water gives ...

Diffusion mediated coagulation and fragmentation based study of domain formation in lipid bilayer membrane

Energy Technology Data Exchange (ETDEWEB)

Rao, Laxminarsimha V., E-mail: laxman@iitk.ac.in [Mechanics and Applied Mathematics Group, Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India); Roy, Subhradeep [Department of Biomedical Engineering and Mechanics (MC 0219), Virginia Tech, 495 Old Turner Street, Blacksburg, VA 24061 (United States); Das, Sovan Lal [Mechanics and Applied Mathematics Group, Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India)

2017-01-15

We estimate the equilibrium size distribution of cholesterol rich micro-domains on a lipid bilayer by solving Smoluchowski equation for coagulation and fragmentation. Towards this aim, we first derive the coagulation kernels based on the diffusion behaviour of domains moving in a two dimensional membrane sheet, as this represents the reality better. We incorporate three different diffusion scenarios of domain diffusion into our coagulation kernel. Subsequently, we investigate the influence of the parameters in our model on the coagulation and fragmentation behaviour. The observed behaviours of the coagulation and fragmentation kernels are also manifested in the equilibrium domain size distribution and its first moment. Finally, considering the liquid domains diffusing in a supported lipid bilayer, we fit the equilibrium domain size distribution to a benchmark solution.

Blood coagulation and fibrinolysis of the whole-body irradiated rabbits

International Nuclear Information System (INIS)

Hishikawa-Itoh, Youko; Ayakawa, Yoshio; Miyata, Nobuki

1984-01-01

To study the effects of irradiation on blood coagulation and fibrinolysis, rabbits were irradiated with 60 Co γ-rays (whole-body: 0, 100, 400, 800, 1200 rads). Clotting time, activity of plasmin and plasminogen, and fibrinogen contents of irradiated rabbit plasma were measured at 4 days before, immediately after, and at 1, 3, 7, 10, and 14 days after irradiation. Both clotting times obtained by addition of (kaolin+phospholipid) which expressed effects on the total intrinsic coagulation system, and by addition of (Ca 2+ ) which expressed effects on the total extrinsic coagulation system, were prolonged with small dose irradiation (100 rads) immediately and 3 days after irradiation. However, with high dose irradiation (400-1200 rads), these clotting times were prolonged 1 day after irradiation. The times of manifestation of irradiation effects on clotting time were different in small and high dose irradiation. Plasmin activity was decreased immediately, 1 day after and recovered 3 days after irradiation. Plasminogen activity was markedly increased in 800 and 1200 rads irradiated groups from 3 days after irradiation. Conversion of plasminogen into plasmin was impaired by irradiation. Fibrinogen contents increased rapidly in all irradiated rabbits except for 100 rads from 1 day after irradiation. These results revealed decreased coagulation and fibrinolysis activities in rabbit blood, irradiation injury of both coagulation and fibrinolysis activation systems, and accumulation of the precursors of fibrin and plasmin (i.e., fibrinogen and plasminogen). (author)

Nanoparticles and the blood coagulation system. Part I: benefits of nanotechnology.

Science.gov (United States)

Ilinskaya, Anna N; Dobrovolskaia, Marina A

2013-05-01

Nanotechnology is proven to provide certain benefits in drug delivery by improving solubility, increasing uptake to target sites and changing pharmacokinetics profiles of traditional drugs. Since properties of many materials change tremendously at the nanoscale levels, nanotechnology is also being explored in various industrial applications. As such, nanoparticles are rapidly entering various areas of industry, biology and medicine. The benefits of using nanotechnology for industrial and biomedical applications are often tempered by concerns about the safety of these new materials. One such area of concern includes their effect on the immune system. While nanoparticle interactions with various constituents of the immune system have been reviewed before, little attention was given to nanoparticle effects on the blood coagulation system. Nanoparticle interface with the blood coagulation system may lead to either benefits to the host or adverse reactions. This article reviews recent advances in our understanding of nanoparticle interactions with plasma coagulation factors, platelets, endothelial cells and leukocytes. Part I is focused on desirable interactions between nanoparticles and the coagulation system, and discusses benefits of using nanotechnology to intervene in coagulation disorders. Undesirable interactions posing safety concerns are covered in part II, which will be published in the June issue of Nanomedicine.

Effect of fibrinogen on blood coagulation detected by optical coherence tomography

International Nuclear Information System (INIS)

Xu, Xiangqun; Teng, Xiangshuai

2015-01-01

Our previous work demonstrated that an optical coherence tomography (OCT) technique and the parameter 1/e light penetration depth (d 1/e ) were able to characterize the whole blood coagulation process in contrast to existing optical tests that are performed on plasma samples. To evaluate the feasibility of the technique for quantifying the effect of fibrinogen (Fbg) on blood coagulation, a dynamic study of d 1/e of blood in various Fbg concentrations was performed in static state. Two groups of blood samples of hematocrit (HCT) in 35, 45, and 55% were reconstituted of red blood cells with: 1) treated plasma with its intrinsic Fbg removed and commercial Fbg added (0–8 g L −1 ); and 2) native plasma with commercial Fbg added (0–8 g L −1 ). The results revealed a typical behavior due to coagulation induced by calcium ions and the clotting time is Fbg concentration-dependent. The clotting time was decreased by the increasing amount of Fbg in both groups. Besides, the blood of lower HCT with various levels of Fbg took shorter time to coagulate than that of higher HCT. Consequently, the OCT method is a useful and promising tool for the detection of blood-coagulation processes induced with different Fbg levels. (paper)

Chemical coagulants and Moringa oleifera seed extract for treating concrete wastewater

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Heber Martins de Paula

2016-01-01

Full Text Available Wastewater from concrete plants has a high pH and a high concentration of suspended solids, necessitating treatment before reuse or discharge into the environment. The objective of this study is to evaluate the efficiency of two chemical coagulants, aluminum sulfate (Al2(SO43 and iron chloride (FeCl3, and a natural coagulant, Moringa oleifera (MO, all in their soluble forms, in the treatment of wastewater from concrete plants. To this end, the efficiencies of the three coagulants, in combinations with different proportions, were tested. The quality parameters of the wastewater obtained after the treatments were compared to the limit values for non-potable water. The use of coagulants in their soluble form potentiates their effect, especially when preparing the MO extract, i.e., greater amounts of the protein responsible for the coagulation is extracted. A mixture with MO and Al2(SO43 in a 20:80 proportion showed the best results, with 97.5% of the turbidity removed at 60 min. of sedimentation, allowing the treated water to be used for washing vehicles and flushing toilets. The FeCl3 treatment produced a high concentration of chlorides, which could cause corrosion problems, and is therefore not recommended for concrete wastewater treatment.

Effect of general anesthesia combined with epidural anesthesia on the postoperative immune function, stress state and coagulation function in patients with laparoscopic cholecystectomy

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Yun-Long Zhao

2017-05-01

Full Text Available Objective: To study the effect of general anesthesia combined with epidural anesthesia on the postoperative immune function, stress state and coagulation function in patients with laparoscopic cholecystectomy. Methods: 98 patients undergoing selective laparoscopic cholecystectomy in our hospital between May 2014 and August 2016 were selected and randomly divided into the combined anesthesia group who accepted the general anesthesia combined with epidural anesthesia and the general anesthesia group who accepted the total intravenous anesthesia (n=49, peripheral blood was collected after operation to detect the number of CD3+CD4+CD8-T cells, CD3+CD4-CD8+T cells, CD16+CD56+NK cells and CD3- CD19+B cells, serum was collected to detect the levels of stress-related endocrine hormones norepinephrine (NE, cortisol (Cor, insulin (Ins, C-peptide (C-P, free triiodothyronine (FT3, free thyroxine (FT4 as well as coagulation function indexes rostaglandin I2 (PGI2, thromboxane A2 (TXA2, 6-ketone-prostaglandin F1α (6-K-PGI1α and thromboxane B2 (TXB2. Results: The number of CD3+CD4+CD8-T cells, CD3+CD4-CD8+T cells, CD16+CD56+NK cells and CD3-CD19+B cells in peripheral blood of combined anesthesia group were significantly higher than those of intravenous anesthesia group (P<0.05; serum NE, Cor, Ins, C-P, FT3, FT4, TXA2 and TXB2 levels of combined anesthesia group were significantly lower than those of intravenous anesthesia group (P<0.05 while PGI2 and 6-K-PGI1α levels were significantly higher than those of intravenous anesthesia group (P<0.05. Conclusions: General anesthesia combined with epidural anesthesia can improve the postoperative immune function, stress state and hypercoagulable state in patients with laparoscopic cholecystectomy.

Outcomes of polytrauma patients with diabetes mellitus

Science.gov (United States)

2014-01-01

Background The impact of diabetes mellitus in patients with multiple system injuries remains obscure. This study was designed to increase knowledge of outcomes of polytrauma in patients who have diabetes mellitus. Methods Data from the Trauma Audit and Research Network was used to identify patients who had suffered polytrauma during 2003 to 2011. These patients were filtered to those with known outcomes, then separated into those with diabetes, those known to have other co-morbidities but not diabetes and those known not to have any co-morbidities or diabetes. The data were analyzed to establish if patients with diabetes had differing outcomes associated with their diabetes versus the other groups. Results In total, 222 patients had diabetes, 2,558 had no past medical co-morbidities (PMC), 2,709 had PMC but no diabetes. The diabetic group of patients was found to be older than the other groups (P <0.05). A higher mortality rate was found in the diabetic group compared to the non-PMC group (32.4% versus 12.9%), P <0.05). Rates of many complications including renal failure, myocardial infarction, acute respiratory distress syndrome, pulmonary embolism and deep vein thrombosis were all found to be higher in the diabetic group. Conclusions Close monitoring of diabetic patients may result in improved outcomes. Tighter glycemic control and earlier intervention for complications may reduce mortality and morbidity. PMID:25026864

SU-F-T-196: Hypo-Fractionation with Intensity Modulated Proton Therapy for Unilateral Metallic Prosthesis Prostate Cancer Patients

Energy Technology Data Exchange (ETDEWEB)

Rana, S; Park, S [McLaren Proton Therapy Center, Karmanos Cancer Institute at McLaren-Flint, Flint, MI (United States); Zheng, Y [Procure Proton Therapy Center, Oklahoma City, OK (United States); Zhang, Y [University of Cincinnati Medical Center, Liberty Township, OH (United States); Pokharel [21st Century Oncology, Estero, FL (United States); Cheng, C [Vantage Oncology, West Hills, CA (United States)

2016-06-15

Purpose: The purpose of this study is to investigate the dosimetric feasibility of hypo-fractionated intensity modulated proton therapy (IMPT) for unilateral metallic prosthesis prostate cancer patients based on proton collaborative group (PCG)-GU002-10 (NCT01230866) protocol criteria. Methods: A total of five unilateral metallic prosthesis prostate cancer cases were included in this retrospective study. For each case, IMPT plans were generated for treatment to be delivered with 7.6 Gy[RBE] per fraction in 5 fractions per week for a total dose of 38 Gy(RBE). Each plan was generated using two anterior-oblique beams and one lateral beam. Treatment plans were optimized with an objective meeting PCG-GU002-10 (NCT01230866) protocol criteria: (i) planning target volume (PTV): D99.5% > 36.1 Gy[RBE], (ii) rectum: V24 < 35%, V33.6 < 10%, (iii) bladder: V39 < 8 cc, and (iv) femoral head: V23 < 1cc. Results: All five cases satisfied PTV D99.5% (average=36.82 Gy[RBE]; range, 36.36–37.13 Gy[RBE]). PTV D95% ranged from 36.66 Gy[RBE] to 38.65 Gy[RBE] and PTV V100 ranged from 95.47% to 97.95%. For the rectum, V24 was less than 35% (average=14.07 Gy[RBE]; range, 6.22–18.42%, whereas V33.6 Gy[RBE] was less than 10% (average=6.83; range, 3.06 – 9.15%). Rectal mean dose ranged from 4.22 Gy[RBE] to 9.97 Gy[RBE]. For the bladder, V39 was found to be less than 8 cc (average=3.69 cc; range, 0.19–7.68 cc). Bladder mean dose ranged from 4.22 Gy[RBE] to 18.83 Gy[RBE]. For the femoral head, V23 was 0 in all five cases. Conclusion: All five unilateral metallic prosthesis prostate cancer IMPT plans generated with one lateral and two anterior-oblique beams satisfied the dosimetric criteria of PCG-GU002-10 (NCT01230866) protocol.

Percutaneous liver biopsy and revised coagulation guidelines: a 9-year experience.

Science.gov (United States)

Kitchin, Douglas R; Del Rio, Alejandro Munoz; Woods, Michael; Ludeman, Lucas; Hinshaw, J Louis

2017-09-19

To retrospectively review revised pre-procedural coagulation guidelines for percutaneous liver biopsy to determine whether their implementation is associated with increased hemorrhagic complications on a departmental scale. Secondary endpoints were to determine the effect of this change on pre-procedural blood product (FFP and platelet) utilization, to evaluate the impact of administered blood products on hemorrhagic complications, and to determine whether bleeding complications were related to INR and platelet levels. This IRB-approved, HIPAA-compliant, retrospective study reviewed 1846 percutaneous liver biopsies in 1740 patients, comparing biopsies performed, while SIR consensus pre-procedural coagulation guidelines were in place (INR ≤ 1.5, platelets ≥50,000 µL) to those performed after departmental implementation of revised, less stringent guidelines (INR ≤ 2.0, platelets ≥25,000 µL). On a departmental scale, there were significantly fewer hemorrhagic complications in the population of patients treated after adoption of less stringent guidelines as compared to those treated under the SIR guidelines (1.6% vs. 3.4%, p = 0.0192) despite a significant decrease in pre-procedural FFP (0.8% vs. 3.9%, p guidelines for percutaneous liver biopsy (INR ≤ 2.0, platelets ≥25,000 µL) did not result in an increase in departmental hemorrhagic complication rates but did significantly decrease pre-procedural FFP/platelet administration. An individual patient's bleeding risk does increase as INR increases and platelets decrease, but pre-procedural FFP and/or platelet transfusion did not mitigate that increased risk.

Aqueous arsenite removal by simultaneous ultraviolet photocatalytic oxidation-coagulation of titanium sulfate

Energy Technology Data Exchange (ETDEWEB)

Wang, Yuxia [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Duan, Jinming, E-mail: jinmingduan@xauat.edu.cn [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Centre for Water Management and Reuse, School of Natural and Built Environments, University of South Australia, Mawson Lakes Campus, South Australia (Australia); Li, Wei [Key Laboratory of Northwest Water Resources, Environment and Ecology, MOE, School of Environmental & Municipal Engineering, Xi’an University of Architecture and Technology (China); Beecham, Simon; Mulcahy, Dennis [Centre for Water Management and Reuse, School of Natural and Built Environments, University of South Australia, Mawson Lakes Campus, South Australia (Australia)

2016-02-13

Highlights: • A simultaneous UV catalysed oxidation–coagulation for As(III) removal is proposed. • As(III) was effectively oxidised to As(V) by the UV catalysed coagulation. • >99% removal for As(III) in pH 4–6 at low doses of Ti(SO{sub 4}){sub 2} was achieved. • Concurrent UV radiation in massive small crystal formation facilitate the effects. • Reaction mechanisms involve both hydroxyl radicals and superoxide radicals. - Abstract: This study explored the efficacy and efficiency of a simultaneous UV-catalyzed oxidation–coagulation process of titanium sulfate (UV/Ti(SO{sub 4}){sub 2}) for efficient removal of As(III) from water. It revealed that, As(III) could be oxidized to As(V) during the UV catalyzed coagulation of Ti(SO{sub 4}){sub 2} with highly efficient As(III) removal in the pH range 4–6{sub .} The UV catalyzed oxidation–coagulation showed surprisingly effective oxidation of As(III) to As(V) within a short time. XPS indicated that 84.7% of arsenic on the coagulated precipitate was in the oxidized form of As(V) after the UV/Ti(SO{sub 4}){sub 2} treatment of As(III) aqueous solutions at pH 5. Arsenic remaining in solution at high pH was in the oxidized form As(V). Removal efficiencies of As(III) were investigated as a function of pH, Ti(SO{sub 4}){sub 2} dosage, initial As(III) concentration and irradiation energy. As(III) could almost completely be removed (>99%) by the photocatalytic oxidation–coagulation process with a moderate dose of Ti(SO{sub 4}){sub 2} in the pH range 4–6 at an initial arsenic concentration of 200 μg/L. The mechanisms of the photocatalytic coagulation oxidation of Ti(SO{sub 4}){sub 2} are similar to those of UV/crystalline TiO{sub 2} particles, involving the formation and reactions of the hydroxyl radical OH· and superoxide HO{sub 2}·/O{sub 2}{sup ·−}.

Quinine-induced disseminated intravascular coagulation.

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Spearing, R L; Hickton, C M; Sizeland, P; Hannah, A; Bailey, R R

Recurrent disseminated intravascular coagulation occurred in 3 women after ingestion of quinine tablets for cramp. All had circulating quinine-dependent antibodies to platelets and in 2 there was initial evidence of antibody consumption, with low titres that rose steeply over the next few days and remained high for many months.

A natural coagulant protein from Moringa oleifera: isolation, characterization, and potential use for water treatment

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Choudhary, Manisha; Neogi, Sudarsan

2017-10-01

In developing countries pond water is still widely used for drinking and household purposes, which develops higher turbidity during rainy seasons and requires a large amount of chemical coagulants, and this leads to high cost of treatment. To mitigate this, it is important to find an economical and natural coagulant to treat turbid water. The present study is focused on using a plant based component as a natural coagulant that is sustainable and environment-friendly. This work focuses on the extraction, isolation and purification of a natural coagulant from seed kernels of Moringa oleifera to enhance its turbidity removal efficiency. The determination of themolecular weight of the purified proteins was done using sodium dodecyl sulfate polyacrylamide gel electrophoresis. The active coagulant proteins were isolated using 30-60% and 60-80% saturation of ammonium sulfate. It was observed that proteins with molecular weight less than 36 kDa have superior coagulation activity. Turbidity removal efficiency of these active coagulant proteins was compared with alum. The possibility of using Moringa oleifera seeds as a natural antimicrobial agent was also investigated.

Data collection of patient outcomes: one institution's experience.

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Whitaker, Thomas J; Mayo, Charles S; Ma, Daniel J; Haddock, Michael G; Miller, Robert C; Corbin, Kimberly S; Neben-Wittich, Michelle; Leenstra, James L; Laack, Nadia N; Fatyga, Mirek; Schild, Steven E; Vargas, Carlos E; Tzou, Katherine S; Hadley, Austin R; Buskirk, Steven J; Foote, Robert L

2018-03-01

Patient- and provider-reported outcomes are recognized as important in evaluating quality of care, guiding health care policy, comparative effectiveness research, and decision-making in radiation oncology. Combining patient and provider outcome data with a detailed description of disease and therapy is the basis for these analyses. We report on the combination of technical solutions and clinical process changes at our institution that were used in the collection and dissemination of this data. This initiative has resulted in the collection of treatment data for 23 541 patients, 20 465 patients with provider-based adverse event records, and patient-reported outcome surveys submitted by 5622 patients. All of the data is made accessible using a self-service web-based tool.

Hibiscus rosa- sinensis leaf extract as coagulant aid in leachate treatment

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Awang, Nik Azimatolakma; Aziz, Hamidi Abdul

2012-12-01

Hibiscus rosa- sinensis is a biodegradable material that has remained untested for flocculating properties. The objective of this study is to examine the efficiency of coagulation-flocculation processes for the removal of color, iron (Fe3+), suspended solids, turbidity and ammonia nitrogen(NH3-N), from landfill leachate using 4,000 mg/L alum in conjunction with H. rosa- sinensis leaf extract (HBaqs). Hydroxyl (O-H) and (carboxyl) C=O functional groups along the HBaqs chain help to indulge flocculating efficiency of HBaqs via bridging. The experiments confirm the positive coagulation properties of HBaqs. The Fe3+ removal rate using 4,000 mg/L alum as sole coagulant was approximately 60 %, and increased to 100 % when 4,000 mg/L alum was mixed with 500 mg/L HBaqs. By mixing, 4,000 mg/L alum with 100-500 mg/L HBaqs, 72 % of SS was removed as compared with only 45 % reduction using 4,000 mg/L alum as sole coagulant.

Clinical outcomes and survival in AA amyloidosis patients

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Yavuz Ayar

Full Text Available Abstract Aim Amyloid A amyloidosis is a rare complication of chronic inflammatory conditions. Most patients with amyloid A amyloidosis present with nephropathy and it leads to renal failure and death. We studied clinical characteristics and survival in patients with amyloid A amyloidosis. Methods: A total of 81 patients (51 males, 30 females with renal biopsy proven amyloid A amyloidosis were analyzed retrospectively. The patients were divided into good and poor outcomes groups according to survival results. Results: Most of the patients (55.6% had nephrotic range proteinuria at diagnosis. Most frequent underlying disorders were familial Mediterranean fever (21.2% and rheumatoid arthritis (10.6% in the good outcome group and malignancy (20% in the poor outcome group. Only diastolic blood pressure in the good outcome group and phosphorus level in the poor outcome group was higher. Serum creatinine levels increased after treatment in both groups, while proteinuria in the good outcome group decreased. Increase in serum creatinine and decrease in estimated glomerular filtration rate of the poor outcome group were more significant in the good outcome group. At the time of diagnosis 18.5% and 27.2% of all patients had advanced chronic kidney disease (stage 4 and 5, respectively. Median duration of renal survival was 65 ± 3.54 months. Among all patients, 27.1% were started dialysis treatment during the follow-up period and 7.4% of all patients underwent kidney transplantation. Higher levels of systolic blood pressure [hazard ratios 1.03, 95% confidence interval: 1-1.06, p = 0.036], serum creatinine (hazard ratios 1.25, 95% confidence interval: 1.07-1.46, p = 0.006 and urinary protein excretion (hazard ratios 1.08, 95% confidence interval: 1.01-1.16, p = 0.027 were predictors of end-stage renal disease. Median survival of patients with organ involvement was 50.3 ± 16 months. Conclusion Our study indicated that familial Mediterranean fever constituted

Performance Evaluation of Five Different Disseminated Intravascular Coagulation (DIC) Diagnostic Criteria for Predicting Mortality in Patients with Complicated Sepsis.

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Ha, Sang Ook; Park, Sang Hyuk; Hong, Sang Bum; Jang, Seongsoo

2016-11-01

Disseminated intravascular coagulation (DIC) is a major complication in sepsis patients. We compared the performance of five DIC diagnostic criteria, focusing on the prediction of mortality. One hundred patients with severe sepsis or septic shock admitted to intensive care unit (ICU) were enrolled. Routine DIC laboratory tests were performed over the first 4 days after admission. The overall ICU and 28-day mortality in DIC patients diagnosed from five criteria (International Society on Thrombosis and Haemostasis [ISTH], the Japanese Association for Acute Medicine [JAAM], the revised JAAM [R-JAAM], the Japanese Ministry of Health and Welfare [JMHW] and the Korean Society on Thrombosis and Hemostasis [KSTH]) were compared. Both KSTH and JMHW criteria showed superior performance than ISTH, JAAM and R-JAAM criteria in the prediction of overall ICU mortality in DIC patients (odds ratio 3.828 and 5.181, P = 0.018 and 0.006, 95% confidence interval 1.256-11.667 and 1.622-16.554, respectively) when applied at day 1 after admission, and survival analysis demonstrated significant prognostic impact of KSTH and JMHW criteria on the prediction of 28-day mortality (P = 0.007 and 0.049, respectively) when applied at day 1 after admission. In conclusion, both KSTH and JMHW criteria would be more useful than other three criteria in predicting prognosis in DIC patients with severe sepsis or septic shock.

Factors associated with outcomes in ruptured aneurysmal patients: Clinical Study of 80 Patients

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Alfotih Gobran Taha Ahmed

2015-03-01

Full Text Available Background: Due to insufficient data in the literature, the optimal timing for surgical intervention for ruptured intracranial aneurysms is still controversial. Some practitioners advocate early surgery, but others not. It is important to identify other factors that can be used to predict poor prognosis in ruptured intracranial aneurysm patients. Objective: To determine the influence of timing of clipping surgery, and other factors on the outcomes of ruptured intracranial aneurysms in Hunt & Hess I~III grade patients. Method: We have performed a retrospective study involving 80 patients who were surgically treated for ruptured intracranial aneurysm between 2007 and 2012. The patient population consisted of 50(62.5% females and 30(37.5% males, with an age range of 12 to 75 years old, mean age 52.33 ± 10.63 years. We measured association between the Glasgow Outcome Scores and Sex, timing of clipping surgery, aneurysm location and pre-operative patient's neurological condition using famous Hunt and Hess grade system. Results: We did not find any correlation between the outcomes of ruptured intracranial aneurysm patients and timing (early, intermediate, late stage of clipping, sex, aneurysm location. Whereas there is a significant correlation between patients outcomes and pre-operative patient neurological condition (Hunt & Hess grade. Conclusion: Timing of Surgery (early, intermediate, late does not affect outcomes in low Hunt and Hess grade patients I~III. Whereas neurological condition (Hunt & Hess has strong impact on postoperative outcomes. Others factors like sex, Age, Aneurysm location have no effect on outcomes in ruptured intracranial aneurysms.

The Relationships Between Doctor-Patient Affectionate Communication and Patient Perceptions and Outcomes.

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Hesse, Colin; Rauscher, Emily A

2018-02-20

The current article combines the literature on doctor-patient communication and affectionate communication. Using Affection Exchange Theory (AET), the study predicts that the need for affection and the benefits of affectionate communication translate to the doctor-patient setting, proposing a series of relationships from both perceived doctor affectionate communication and affection deprivation to several patient outcome variables (patient perception of the doctor, patient communication with the doctor, and patient satisfaction/adherence). The results strongly supported the predictions for both affectionate communication and affection deprivation, with affectionate communication positively relating to most outcome measures and affection deprivation negatively relating to most outcome measures. Affection deprivation served as a moderator for the relationship between provider competence and patient satisfaction, although affectionate communication moderated the relationship between provider competence and patient adherence. Implications and possible directions for future research are discussed.

Potential of Hibiscus Sabdariffa and Jatropha Curcas as Natural Coagulants in the Treatment of Pharmaceutical Wastewater

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Sibartie Sheena

2018-01-01

Full Text Available Pharmaceutical wastewater is one of the most difficult wastewater to treat due to the presence of pharmaceutical compounds resulting in high concentration of organic matter, high turbidity and Chemical Oxygen Demand (COD. Chemical-based coagulation is a common method used to treat wastewater. However, the issue that has been raised with the use of chemical coagulants is their presence in water after treatment that can cause risks to the human health such as Alzheimer and cancer. Natural coagulants can be used as a safe alternative to these chemicals instead. Therefore, the objective of this experiment was to study the effect of H. Sabdariffa and J. Curcas as natural coagulants, separately and as a combination, on the treatment of pharmaceutical wastewater. Jar test experiment were carried out where beakers of 0.5L wastewater were mixed with the coagulants. The pH of the wastewater was varied from 2 to 12 while the coagulant dosage was varied from 40 to 200 mg/L. It was found that H. Sabdariffa works best at pH 4 and at a coagulant dosage of 190 mg/L with a highest turbidity removal of 35.8% and a decrease of COD by 29%. J. Curcas was found to perform best at pH 3 and with a coagulant dosage of 200 mg/L with a highest turbidity removal of 51% and a decrease of COD by 32%. When J. Curcas and H. Sabdariffa were used in combination, the optimum composition was found to be 80% J. Curcas and 20% H. Sabdariffa by weight with a maximum turbidity removal of 46.8% and a decrease in COD by 46%. In comparison between the two natural coagulants, J. Curcas is found to be a better and more suited coagulative agent for the treatment of pharmaceutical wastewater. The same experiment was carried with alum at pH 6 and coagulant dosage of 750 mg/L and a turbidity removal of 48% and a decrease in COD by 38% were recorded. In comparison with alum, J. Curcas was a better coagulant in treating the pharmaceutical wastewater. This shows that natural coagulants can be