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Cureus May 2024Laparoscopic cholecystectomy (LC) is universally accepted as the gold standard treatment for symptomatic gallstones. However, it has some drawbacks. Some of the major...
Comparative Study of Levels of Serum Bilirubin, Serum Transaminase, Serum Alkaline Phosphatase, and Prothrombin Time After Laparoscopic Cholecystectomy and Open Cholecystectomy.
Laparoscopic cholecystectomy (LC) is universally accepted as the gold standard treatment for symptomatic gallstones. However, it has some drawbacks. Some of the major drawbacks of LC include increased bile duct injuries and longer operation time. Furthermore, it may cause changes in the body systems, such as alterations in acid-base, pulmonary status, cardiovascular system, and liver function. Thus far, no causes for these changes have been identified. This study aimed to evaluate the effect of laparoscopic and open cholecystectomy on liver enzymes, prothrombin time (PT), and serum bilirubin. In the current study, we found significant increases in aspartate transferase (AST), alanine transaminase (ALT), and total bilirubin, on day 1 and day 3 after LC but no significant change in alkaline phosphatase (ALKP) and PT. It is important for surgeons to know about these transient changes in the immediate postoperative period to avoid misdiagnosis and adopt proper treatment and management.
PubMed: 38872670
DOI: 10.7759/cureus.60296 -
Alternative Therapies in Health and... Jun 2024Hyponatremia is one of the main types of complications of primary nephrotic syndrome in children, which can cause significant damage to the patient's nervous system and...
OBJECTIVE
Hyponatremia is one of the main types of complications of primary nephrotic syndrome in children, which can cause significant damage to the patient's nervous system and can lead to death or shock if not intervened early. In addition, patients are relatively young and often need to pay attention to the nursing cooperation of various key points in order to achieve ideal clinical treatment effects. To analyze the key points of nursing cooperation and the implementation effects of primary nephrotic syndrome in children complicated with hyponatremia.
METHODS
A retrospective analysis of 100 children with primary nephrotic syndrome complicated with hyponatremia admitted to our Hospital from January 2018 to November 2022 was conducted as the study objects. They were divided into a control and observation groups, with 50 cases each. Among them, the control group received routine nursing, while the observation group paid attention to various key points of nursing cooperation. This includes paying close attention to changes in plasma osmotic pressure, blood sodium, and electrocardiogram indicators, being alert to the above situations, and taking appropriate treatment measures in a timely manner; nursing staff need to guide family members to cooperate in alleviating clinical related symptoms, guide family members to avoid giving children irritating foods, and control the intake of sodium chloride. Guide parents to adjust their clothing and keep their skin dry and clean. Guide parents to provide psychological support for children and other key points of nursing cooperation. After different nursing measures were taken for the two groups, the scores of Quality of Life Core Questionnaire Scale related to patients after nursing, renal functions after nursing, and coagulation function indicators after nursing of the two groups were evaluated. Simultaneously compare the nursing efficacy, incidence of adverse reactions, and overall satisfaction rate of their family members between the two groups.
RESULTS
The scores of the core questionnaire scale of quality of life after nursing (physical function, emotional function, cognitive function, social function), coagulation function indexes after nursing (prothrombin time, activated partial thromboplastin), nursing efficacy, and the total satisfaction rate of patients' families were compared between the two groups. The observation group was higher than the control group (P < .05). The renal function indexes after nursing (serum creatinine, urea nitrogen, α1-microglobulin, 24h urine protein quantitative) and the incidence of adverse reactions (gastrointestinal discomfort, hypoglycemia, abnormal liver function) were compared between the two groups. The observation group was lower than the control group (P < .05).
CONCLUSION
As an auxiliary treatment intervention measure, the clinical effects obtained from the practice of nursing cooperation of each key point and the support of family members provide important strategic guidance for the selection of nursing strategies for children with primary nephrotic syndrome and hyponatremia. Such potential improvements have greatly promoted the improvement of the quality and efficiency of the entire department of pediatric nephrology and nursing, and are worthy of clinical promotion. That is, the focus of nursing cooperation should pay attention to the key points of nursing cooperation for children with primary nephrotic syndrome and hyponatremia to improve the quality of life of patients. Future studies can explore the universality of the application effect of relevant nursing points in other children.
PubMed: 38870508
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024To evaluate the impact of Pender-based health education on outcomes in rivaroxaban-treated lower limb DVT patients.
OBJECTIVE
To evaluate the impact of Pender-based health education on outcomes in rivaroxaban-treated lower limb DVT patients.
METHODS
103 patients with DVT of the lower limbs treated with rivaroxaban admitted to The First Affiliated Hospital of Xi'an Jiaotong University from January 2022 to January 2023 were included in the study and were randomly divided into the conventional group (n=52, receiving routine care with medication instruction, exercise instruction, and psychological care as the main components) and the Pender group (n=51, giving health education based on the Pender health promotion model in addition to conventional care) to compare the recurrence rate of DVT of the lower limbs, DVT of the lower limbs clinical condition, complication rate, quality of life score, coagulation index and nursing satisfaction rate in the two groups.
PRIMARY RESULTS
The recurrence rate of lower limb DVT, circumference of the affected limb, time to get out of bed, and time to reduce swelling in the Pender group were lower (shorter) than those in the conventional group (P < .05); after the intervention, all quality of life scores in the Pender group were higher than those in the conventional group (P < .05).
SECONDARY RESULTS
The complication rate, fibrinogen (FIB) and D-dimer (D-D) levels were lower (shorter) in the Pender group than in the conventional group (P < .05). After the intervention, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were higher in the Pender group than in the conventional group (P < .05).
CONCLUSION
The health education based on the Pender health promotion model is effective in patients with lower limb DVT treated with rivaroxaban, which can effectively reduce recurrence and complications, optimize coagulation indexes, and improve the quality of life and nursing care satisfaction by improving the patients' health cognition and health behaviors, which is of great value in clinical application and promotion.
PubMed: 38870500
DOI: No ID Found -
Thrombosis and Haemostasis Jun 2024Prethrombin-1 is a Gla-domain lacking enzymatically inactive split product that results from the cleavage of fragment 1 from prothrombin by thrombin in a feedback...
INTRODUCTION
Prethrombin-1 is a Gla-domain lacking enzymatically inactive split product that results from the cleavage of fragment 1 from prothrombin by thrombin in a feedback reaction.
METHODS
A prethrombin-1 preparation derived from human plasma was tested for its hemostatic and thrombogenic properties. Animal models of nail clipping (for rabbits) and tail clipping (for mice) were developed to measure blood loss in FVIII-inhibitor or rivaroxaban anticoagulated rabbits and mice, respectively. A modified Wessler test was used in rabbits to assess the thrombogenic potential by Wessler score and clot weight. Studies were performed in groups of three to six for prethrombin-1 dose escalation and comparison with prothrombin, Beriplex®, FEIBA®, and saline as a control. Data were analyzed using t-statistics or the Mann Whitney U test as applicable.
RESULTS
Prethrombin-1 has excellent hemostatic properties in anticoagulated mouse and rabbit bleeding models. Wessler tests suggest that in contrast to activated and nonactivated prothrombin complexes, prethrombin-1 has negligible thrombogenic potential.
CONCLUSION
The thrombin zymogen prethrombin-1 promotes hemostasis with reduced risk of thrombosis. Prethrombin-1 may have potential to become a life-saving treatment for patients who bleed or are at risk of bleeding.
PubMed: 38866044
DOI: 10.1055/s-0044-1787720 -
Journal of Infection in Developing... May 2024Chronic HC leads to the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The treatment of chronic HC with DAAs reduces mortality from LC and...
INTRODUCTION
Chronic HC leads to the development of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). The treatment of chronic HC with DAAs reduces mortality from LC and HCC. The study aimed to investigate the serological markers specific to HCC (PIVKA-II and AFP) in patients with chronic HC before and after DAA treatment.
METHODOLOGY
The study involved 35 HCV patients (mean age: 56.23 ± 1.45) divided into two groups. Group 1 included 15 HCV + HCC patients and Group 2 included 20 HCV non-HCC patients.
RESULTS
At the end of treatment all the patients were HCV RNA negative. Three months after the end of antiviral treatment, HCV RNA was undetectable in all patients, while a complete biochemical and virological response was observed in 66.7% of HCV + HCC patients and 85.0% of HCV non-HCC patients. PIVKA-II levels before the initiation of antiviral treatment were high in all patients. At the end of the treatment, in the HCV non-HCC group, normalization of PIVKA-II levels was observed only in 20.0% cases, and in 60.0% of cases 3 months after the treatment. Meanwhile, in patients with HCC and chronic HCV, PIVKA-II levels were within the normal range 3 months after treatment in only 13.3% of patients.
CONCLUSIONS
It is necessary to monitor HCV patients with cirrhosis (F4) and severe fibrosis (F3) without HCC, who have high PIVKA-II and AFP levels and/or ALT activity despite obtaining sustained virologic response 3 months after treatment with DAAs.
Topics: Humans; Hepatitis C, Chronic; Carcinoma, Hepatocellular; Antiviral Agents; Middle Aged; Male; Liver Neoplasms; Female; Biomarkers; alpha-Fetoproteins; Prothrombin; Liver Cirrhosis; Aged
PubMed: 38865409
DOI: 10.3855/jidc.18410 -
Frontiers in Immunology 2024This study aimed to develop a prognostic nomogram for predicting the recurrence-free survival (RFS) of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)...
Machine learning-based model for predicting tumor recurrence after interventional therapy in HBV-related hepatocellular carcinoma patients with low preoperative platelet-albumin-bilirubin score.
INTRODUCTION
This study aimed to develop a prognostic nomogram for predicting the recurrence-free survival (RFS) of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients with low preoperative platelet-albumin-bilirubin (PALBI) scores after transarterial chemoembolization (TACE) combined with local ablation treatment.
METHODS
We gathered clinical data from 632 HBV-related HCC patients who received the combination treatment at Beijing You'an Hospital, affiliated with Capital Medical University, from January 2014 to January 2020. The patients were divided into two groups based on their PALBI scores: low PALBI group (n=247) and high PALBI group (n=385). The low PALBI group was then divided into two cohorts: training cohort (n=172) and validation cohort (n=75). We utilized eXtreme Gradient Boosting (XGBoost), random survival forest (RSF), and multivariate Cox analysis to pinpoint the risk factors for RFS. Then, we developed a nomogram based on the screened factors and assessed its risk stratification capabilities and predictive performance.
RESULTS
The study finally identified age, aspartate aminotransferase (AST), and prothrombin time activity (PTA) as key predictors. The three variables were included to develop the nomogram for predicting the 1-, 3-, and 5-year RFS of HCC patients. We confirmed the nomogram's ability to effectively discern high and low risk patients, as evidenced by Kaplan-Meier curves. We further corroborated the excellent discrimination, consistency, and clinical utility of the nomogram through assessments using the C-index, area under the curve (AUC), calibration curve, and decision curve analysis (DCA).
CONCLUSION
Our study successfully constructed a robust nomogram, effectively predicting 1-, 3-, and 5-year RFS for HBV-related HCC patients with low preoperative PALBI scores after TACE combined with local ablation therapy.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Male; Female; Middle Aged; Machine Learning; Bilirubin; Neoplasm Recurrence, Local; Nomograms; Hepatitis B virus; Chemoembolization, Therapeutic; Prognosis; Blood Platelets; Hepatitis B; Adult; Serum Albumin; Retrospective Studies; Platelet Count
PubMed: 38863693
DOI: 10.3389/fimmu.2024.1409443 -
Nigerian Journal of Clinical Practice May 2024Preeclampsia, a pregnancy complication associated with significant maternal and perinatal mortality and morbidity, has been found to be closely linked to dysfunction in...
BACKGROUND AND AIM
Preeclampsia, a pregnancy complication associated with significant maternal and perinatal mortality and morbidity, has been found to be closely linked to dysfunction in the blood coagulation-fibrinolysis system. However, the relationship between hematologic data and severity and onset time of preeclampsia remains unclear. This study aimed to identify specific hematologic parameters in both preeclamptic and normotensive pregnant women and determine their potential significance in the pathogenesis of preeclampsia.
MATERIALS AND METHODS
A total of 112 patients with gestational hypertension disease were divided into two groups: early-onset preeclampsia (32 cases) and late-onset preeclampsia (80 cases). A control group of 82 normotensive pregnant women matched for age and parity was also selected. Blood samples were collected from all participants to test for specific hematologic parameters.
RESULTS
Mild and severe preeclampsia were associated with lower hemoglobin level (P = 0.01 and P = 0.03, respectively), higher mean platelet volume (P = 0.01 and P = 0.01, respectively) and fibrinogen (P = 0.01 and P = 0.01, respectively), and shorter prothrombin time (P = 0.02 and P = 0.01, respectively) and activated partial thromboplastin time (P = 0.01 and P = 0.02, respectively).
CONCLUSION
These findings have provided evidence on the hematologic coagulative actors in the pathogenesis and severity of preeclampsia.
Topics: Humans; Female; Pregnancy; Adult; Pre-Eclampsia; Case-Control Studies; Hypertension, Pregnancy-Induced; Blood Coagulation; Severity of Illness Index; Young Adult; Fibrinogen; Prothrombin Time; Mean Platelet Volume; Hemoglobins; Partial Thromboplastin Time
PubMed: 38842709
DOI: 10.4103/njcp.njcp_645_23 -
Frontiers in Endocrinology 2024A prothrombotic state was demonstrated in patients with Cushing's syndrome and is involved in the development and progression of cardiovascular and renal damage in...
BACKGROUND AND AIMS
A prothrombotic state was demonstrated in patients with Cushing's syndrome and is involved in the development and progression of cardiovascular and renal damage in hypertensive patients. This study was designed to examine the relationships between cortisol secretion and the hemostatic and fibrinolytic systems in hypertension.
METHODS
In 149 middle-aged, nondiabetic, essential hypertensive patients free of cardiovascular and renal complications, we measured hemostatic markers that express the spontaneous activation of the coagulation and fibrinolytic systems and assessed daily cortisol levels (8 AM, 3 PM, 12 AM; area under the curve, AUC-cortisol) together with the cortisol response to dexamethasone overnight suppression (DST-cortisol).
RESULTS
Plasma levels of D-dimer (D-dim), prothrombin fragment 1 + 2 (F1 + 2), and von Willebrand factor (vWF) were progressively and significantly higher across tertiles of AUC-cortisol and DST-cortisol, whereas no differences were observed in fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor-1, antithrombin III, protein C, and protein S. D-dim, F1 + 2, and vWF were significantly and directly correlated with age and both AUC-cortisol and DST-cortisol. Multivariate regression analysis showed that both AUC-cortisol and DST-cortisol were related to plasma D-dim, F1 + 2, and vWF independently of age, body mass index, blood pressure, and renal function.
CONCLUSION
Greater daily cortisol profile and cortisol response to overnight suppression are independently associated with a prothrombotic state in hypertensive patients and might contribute to the development of organ damage and higher risk of cardiovascular complications.
Topics: Humans; Male; Middle Aged; Female; Hydrocortisone; Dexamethasone; Hypertension; Adult; Thrombosis; von Willebrand Factor; Circadian Rhythm; Aged; Biomarkers
PubMed: 38836224
DOI: 10.3389/fendo.2024.1397062 -
Cureus May 2024Background Of liver-related disorders, cirrhosis is currently the leading cause of death and has become a significant global public health concern. Aspartate...
Background Of liver-related disorders, cirrhosis is currently the leading cause of death and has become a significant global public health concern. Aspartate aminotransferase to platelet ratio index (APRI), a newer prognostic modality, is a very effective noninvasive diagnostic for identifying advanced liver fibrosis. Methods A prospective observational study was conducted among individuals with liver disease, 100 cases and 100 controls for two years. All the sociodemographic details, clinical features of the patients, and clinical findings such as prothrombin time (PT), liver function tests, kidney function tests, and total blood count were recorded using a pretested semi-structured questionnaire. Results According to our survey results, 48% of the participants were between the ages of 40 and 60. Regarding aPTT (activated partial thromboplastin time) and liver function test characteristics (serum glutamic-oxaloacetic transaminase(SGOT), serum glutamic pyruvic transaminase (SGPT)), we showed a substantial difference between the patients and controls. Regarding the APRI distribution, we also found a statistically significant variation between the research groups. When we compared the validity of APRI scores in diagnosing cirrhosis, we discovered that the ideal cutoff value of APRI was determined to be 3.99, with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 33%, 86%, 70%, and 56%, respectively. The area under the receiver operating characteristic (ROC) curve for APRI in detecting cirrhosis was also 0.693. Conclusion Thus, our study results conclude that APRI is a crucial noninvasive prognostic tool that can be utilized to prognostize liver cirrhosis.
PubMed: 38836137
DOI: 10.7759/cureus.59680