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Brazilian Journal of Medical and... 2021This study aimed to explore the effect of intravenous thrombolysis with alteplase on clinical efficacy, inflammatory factors, and neurological function in patients with...
This study aimed to explore the effect of intravenous thrombolysis with alteplase on clinical efficacy, inflammatory factors, and neurological function in patients with acute cerebral infarction. A total of 120 patients with acute cerebral infarction were divided into two groups by the random number table method, with 60 patients in each group: observation group (intravenous thrombolysis with alteplase) and control group (intravenous thrombolysis with batroxobin). The clinical efficacy after a 14-day treatment was observed. Serum C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), CD62p, GMP-140, and neuron-specific enolase (NSE) were measured. Scores of National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MoCA) were determined. The total effective rate in the observation group was 81.67%, which was higher than the 61.67% in the control group (P<0.05). The improvement of inflammatory factors (CRP, TNF-α, IL-6, CD62p, GMP-140, and NSE), NIHSS, MMSE, and MoCA in the observation group was superior to that in the control group (all P<0.05). The modified Rankin scale at three months after hospital discharge in the observation group was lower than that in the control group (P<0.01). Intravenous thrombolysis with alteplase for acute cerebral infarction can enhance the clinical efficacy, alleviate inflammatory response and brain injury, and improve cognitive function, which is worthy of further clinical application and study.
Topics: Brain Ischemia; Cerebral Infarction; Fibrinolytic Agents; Humans; Stroke; Thrombolytic Therapy; Tissue Plasminogen Activator; Treatment Outcome
PubMed: 33729386
DOI: 10.1590/1414-431X202010000 -
Medicine Apr 2024The objective of this study was to explore the real-world incidence, severity, clinical features, and potential risk factors associated with hypofibrinogenemia induced...
The objective of this study was to explore the real-world incidence, severity, clinical features, and potential risk factors associated with hypofibrinogenemia induced by hemocoagulase. Based on Chinese Hospital Pharmacovigilance System, a retrospective case-control study was conducted, enrolling hospitalized patients who received hemocoagulase for the treatment or prevention of hemorrhage in Weifang People's Hospital in China from January 2021 to May 2022. Univariate and multivariate logistic regression was performed to analyze the potential risk factors. Out of 10,397 hospitalized patients who received hemocoagulase, 341 patients showed positive triggers, with 235 patients ultimately conformed as hemocoagulase-associated hypofibrinogenemia. The system positive alarm rate was 68.91%, and the overall incidence of hemocoagulase-induced hypofibrinogenemia was 2.26%, predominantly characterized by mild to moderate severity levels. The incidence varied among the 4 types of hemocoagulase, with the highest incidence observed in hemocoagulase Agkistrodon Halys Pallas at 4.59%. The incidence of hemocoagulase from Deinagkistrodon acutus, Bothrops Atrox and Adder were 0.97%, 0.44% and 0.12%, respectively. Multivariate logistic regression analysis revealed that age (odds ratios [OR] = 177.328, P < .001), source of snake venom (OR = 5.641, P < .05), albumin (OR = 2.487, P < .001), and cumulative dosage (OR = 1.106, P < .001) were independent risk factors. Increased risk of hemocoagulase-related hypofibrinogenemia may be associated with children, elderly patients, low albumin levels, high cumulative doses and hemocoagulase from Agkistrodon Halys Pallas. Early recognition and close drug monitoring for these high-risk patients are vital in clinical practice.
Topics: Child; Aged; Animals; Humans; Retrospective Studies; Case-Control Studies; Afibrinogenemia; Batroxobin; Incidence; Albumins; Risk Factors; Crotalinae; Venomous Snakes
PubMed: 38608074
DOI: 10.1097/MD.0000000000037773 -
Indian Journal of Dental Research :... 2022Glanzmann thrombasthenia is a rare platelet disorder affecting 0.0001% of the population. Dentists may often be unaware of this condition, and manipulation of soft...
THE RATIONALE
Glanzmann thrombasthenia is a rare platelet disorder affecting 0.0001% of the population. Dentists may often be unaware of this condition, and manipulation of soft tissue can lead to grave consequences, which may even result in fatality.
PATIENT CONCERNS
In this case report, a 4-year-old patient with Glanzmann thrombasthenia reported to the department with a chief complaint of a discoloured tooth.
CLINICAL FINDINGS
On examination, 51 was nonvital, and pulpectomy was the treatment planned. The non-vital anterior tooth was treated with a pulpectomy procedure. There was uncontrolled bleeding during the procedure.
TREATMENT
A topical solution of BotroClot was used to arrest the bleeding, and obturation was completed following that. The post-operative period was uneventful.
TAKE-AWAY LESSONS
Case report explored the use of a topical hemostatic agent to arrest bleeding from the canal. This case report warrants eliciting a thorough medical history before any dental procedure.
Topics: Batroxobin; Child, Preschool; Hemorrhage; Hemostatics; Humans; Thrombasthenia; Tooth, Deciduous
PubMed: 36254965
DOI: 10.4103/ijdr.ijdr_1191_21 -
Journal of Orthopaedic Research :... Oct 2017Intervertebral disc regeneration is quickly moving towards clinical applications. However, it is still missing an ideal injectable hydrogel to support mesenchymal stem...
Intervertebral disc regeneration is quickly moving towards clinical applications. However, it is still missing an ideal injectable hydrogel to support mesenchymal stem cells (MSC) delivery. Herein, a new injectable hydrogel composed of platelet rich plasma (PRP) and hyaluronic acid (HA) blended with batroxobin (BTX) as gelling agent, was designed to generate a clinically relevant cell carrier for disc regeneration. PRP/HA/BTX blend was tested for rheological properties. Amplitude sweep, frequency sweep, and rotational measurements were performed and viscoelastic properties were evaluated. Human MSC encapsulated in PRP/HA/BTX hydrogel were cultured in both growing medium and medium with or without TGF-β1 up to day 21. The amount of glycosaminoglycan was evaluated. Quantitative gene expression evaluation for collagen type II, aggrecan, and Sox 9 was also performed. Rheological tests showed that the hydrogel jellifies in 15 min 20°C and in 3 min at 37°C. Biological test showed that MSCs cultured in the hydrogel maintain high cell viability and proliferation. Human MSC within the hydrogel cultured with or without TGF-β1 showed significantly higher GAG production compared to control medium. Moreover, MSCs in the hydrogel underwent differentiation to chondrocyte-like cells with TGF-β1, as shown by histology and gene expression analysis. This novel hydrogel improves viability and proliferation of MSCs supporting the differentiation process toward chondrocyte-like cells. Rheology tests showed optimal gelation kinetics at room temperature for manipulation and faster gelation after transplantation (37°C). The clinical availability of all components of the hydrogel will allow a rapid translation of this regenerative approach into the clinical scenario. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2109-2116, 2017.
Topics: Batroxobin; Healthy Volunteers; Humans; Hyaluronic Acid; Hydrogels; Mesenchymal Stem Cell Transplantation; Platelet-Rich Plasma; Rheology
PubMed: 28019703
DOI: 10.1002/jor.23509 -
PloS One 2015Lance-headed snakes are found in Central and South America, and they account for most snakebites in Brazil. The phylogeny of South American pitvipers has been reviewed,...
Lance-headed snakes are found in Central and South America, and they account for most snakebites in Brazil. The phylogeny of South American pitvipers has been reviewed, and the presence of natural and non-natural hybrids between different species of Bothrops snakes demonstrates that reproductive isolation of several species is still incomplete. The present study aimed to analyze the biological features, particularly the thrombin-like activity, of venoms from hybrids born in captivity, from the mating of a female Bothrops erythromelas and a male Bothrops neuwiedi, two species whose venoms are known to display ontogenetic variation. Proteolytic activity on azocoll and amidolytic activity on N-benzoyl-DL-arginine-p-nitroanilide hydrochloride (BAPNA) were lowest when hybrids were 3 months old, and increased over body growth, reaching values similar to those of the father when hybrids were 12 months old. The clotting activity on plasma diminished as hybrids grew; venoms from 3- and 6-months old hybrids showed low clotting activity on fibrinogen (i.e., thrombin-like activity), like the mother venom, and such activity was detected only when hybrids were older than 1 year of age. Altogether, these results point out that venom features in hybrid snakes are genetically controlled during the ontogenetic development. Despite the presence of the thrombin-like enzyme gene(s) in hybrid snakes, they are silenced during the first six months of life.
Topics: Animals; Batroxobin; Blood Coagulation; Bothrops; Cattle; Crotalid Venoms; Female; Hybridization, Genetic; Male; Morphogenesis; Proteolysis; Thrombin
PubMed: 26714190
DOI: 10.1371/journal.pone.0145516 -
The American Journal of Case Reports Mar 2017BACKGROUND In patients with large colon polyps, late-onset bleeding may be more likely to occur because of the larger cutting surface. In these patients, hemostatic...
BACKGROUND In patients with large colon polyps, late-onset bleeding may be more likely to occur because of the larger cutting surface. In these patients, hemostatic agents may be applied to prevent the late-onset bleeding. A total of 7 patients developed hypofibrinogenemia caused by hemocoagulase following excision of colon polyps in our center from November to December 2015. CASE REPORT Seven patients underwent excision of colon polyps in our center from November to December 2015. The cutting face was large in these patients after surgery; therefore, hemocoagulase was used to prevent potential late-onset bleeding. Evaluation of clotting function showed that the fibrinogen level was normal before surgery in all 7 patients. Hemocoagulase was intravenously administered twice daily beginning from postoperative day 1. Hypofibrinogenemia of varying severity occurred 2-4 d later. Three patients also had lower-gastrointestinal bleeding. After drug withdrawal and infusion of fibrinogen, blood fibrinogen level gradually returned to normal. In contrast, among 13 patients who had not received hemocoagulase treatment for preventing hemorrhage following excision of colon polyps, detection of blood fibrinogen before surgery and 2-4 d after showed normal results. CONCLUSIONS Routine use of Hemocoagulase For Injection for the prevention of late-onset bleeding is not recommended for patients who have undergone excision of colon polyps. Hemocoagulase following excision of colon polyps can cause hypofibrinogenemia and even lower-gastrointestinal bleeding.
Topics: Afibrinogenemia; Batroxobin; Colonic Polyps; Gastrointestinal Hemorrhage; Hemostatics; Humans; Postoperative Hemorrhage
PubMed: 28325889
DOI: 10.12659/ajcr.902059 -
Renal Failure Nov 2017Rectus sheath hematomas (RSHs) are uncommon. They are usually unilateral and rarely bilateral. In this paper, we report the first case of spontaneous bilateral RSHs in a...
Rectus sheath hematomas (RSHs) are uncommon. They are usually unilateral and rarely bilateral. In this paper, we report the first case of spontaneous bilateral RSHs in a uremic patient after the administration of the first dose of low-molecular weight heparin during hemodialysis. The most interesting aspect of this case is that the main symptom of RSH in our patient was urinary bladder irritation. We highlight the importance of the prompt diagnosis and management of this medical emergency.
Topics: Abdominal Pain; Administration, Intravenous; Anticoagulants; Batroxobin; Blood Component Transfusion; Hematoma; Hemostatics; Heparin, Low-Molecular-Weight; Humans; Hyperkalemia; Male; Middle Aged; Plasma; Rectus Abdominis; Renal Dialysis; Thrombosis; Tomography, X-Ray Computed; Ultrasonography; Uremia; Urinary Bladder Diseases
PubMed: 28330422
DOI: 10.1080/0886022X.2017.1305406 -
Indian Journal of Hematology & Blood... Apr 2018Hemocoagulase Agkistrodon Halys Pallas, a well-established hemostatic agent used in China, has widespread applications in various conditions of bleeding and hemorrhages....
Hemocoagulase Agkistrodon Halys Pallas, a well-established hemostatic agent used in China, has widespread applications in various conditions of bleeding and hemorrhages. Although it presents a low risk of vascular thrombosis, the agent can be easily tolerated and does not show any harmful effects, except allergy. However, long-term use of hemocoagulase may induce hypofibrinogenemia in some patients. Herein, we report 11 patients of prolonged administration of hemocoagulase Agkistrodon, with particular attention to the dynamic changes in their coagulation functions. A marked decline in the level of fibrinogen was observed in patients suffering from hematological disorders, following an extended exposure to hemocoagulase. Nevertheless, the low fibrinogen levels increased after withdrawal of the agent. Since the D-dimer level did not show any significant increase, hemocoagulase inducing lower fibrinogen may be considered to be a process of primary fibrinolysis. In conclusion, we suggested that hemocoagulase must be cautiously used in patients with hematological disorders, because of the potential risk of fibrinolysis; and the coagulation functions should be carefully evaluated during the administration of hemocoagulase.
PubMed: 29622877
DOI: 10.1007/s12288-017-0859-z -
Journal of Cancer Research and... Sep 2020In this study, we reported seven patients who underwent diagnostic evaluation through core-needle biopsy (CNB) of the spleen. After biopsy, gelatin sponge particles...
In this study, we reported seven patients who underwent diagnostic evaluation through core-needle biopsy (CNB) of the spleen. After biopsy, gelatin sponge particles mixed with hemocoagulase were gradually injected using a coaxial introducer needle. One patient received microwave ablation following the CNB. All patients were followed up by computed tomography to rule out bleeding or accidental injuries both immediately after the biopsy and within 24 h. Adequate specimens for pathologic examination were obtained from all patients, and the biopsy technical success rate was 100%. No serious complications were observed in our case series. There was no evidence of postbiopsy bleeding. Therefore, injection of gelatin sponge particles mixed with hemocoagulase or microwave ablation may be effective options to prevent hemorrhage after splenic core-needle biopsies.
Topics: Adult; Aged; Aged, 80 and over; Batroxobin; Biopsy, Large-Core Needle; Female; Gelatin Sponge, Absorbable; Hemorrhage; Humans; Image-Guided Biopsy; Male; Middle Aged; Postoperative Complications; Spleen; Tomography, X-Ray Computed
PubMed: 33004768
DOI: 10.4103/jcrt.JCRT_815_19 -
Current Drug Safety 2019Hemocoagulase agkistrodon has been widely used for visceral bleeding, however, its adverse reaction has not been fully recognized.
BACKGROUND
Hemocoagulase agkistrodon has been widely used for visceral bleeding, however, its adverse reaction has not been fully recognized.
CASE REPORT
A 65-year-old female with upper gastrointestinal hemorrhage occurred severe coagulation disorder during her hospitalization. Transfusion of blood products can not improve coagulation function. Coagulation parameters returned to normal two days after discontinuation of hemocoagulase agkistrodon.
CONCLUSION
So intravenous administration of hemocoagulase should be cautiously used for the treatment of gastrointestinal bleeding.
Topics: Aged; Batroxobin; Blood Coagulation Factors; Gastrointestinal Hemorrhage; Humans
PubMed: 31124425
DOI: 10.2174/1574886314666190524093711