China
Africa
Explore chapters and articles related to this topic
Stroke
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
When there are thrombotic disorders causes of ischemic stroke, blood tests can be done. Routine tests usually include complete blood count (CBC), platelet count, fasting blood glucose, lipid profile, and prothrombin time/partial thromboplastin time (PT/PTT). Other tests include homocysteine measurement, antiphospholipid antibodies, antinuclear antibodies, erythrocyte sedimentation rate, rheumatoid factor, hemoglobin electrophoresis, syphilis serologic testing, and urinalysis for amphetamines or cocaine.
Anesthesia for Patients with Ventricular Assist Devices
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
For an elective VAD placement the blood bank should be alerted to initially order 10 units of PRBC, 4 units of FFP and two 8 packs of platelets. In addition, 10 units of cryoprecipitate may be necessary. If blood products are required, serial coagulation tests are performed including prothrombin time (PT), partial thromboplastin time (PTT), platelet count and fibrinogen studies.
Blood Coagulation and Fibrinolysis in TTP and HUS
Published in Pia Glas-Greenwalt, Fibrinolysis in Disease Molecular and Hemovascular Aspects of Fibrinolysis, 2019
Juan Monteagudo, Arturo Pereira
The routine laboratory tests of hemostasis are normal or near normal in most patients with TTP and HUS. In fact, marked prolongation of the prothrombin time (PT) or activated partial thromboplastin time (aPTT), abnormally decreased levels of fibrinogen, and/or the presence of fibrin/ogen split products should cast doubt upon the diagnosis of TTP/HUS. However, profound alterations of these laboratory tests can be found in patients with advanced disease and superimposed disseminated intravascular coagulation.11-14 In our series of 31 patients with TTP/HUS, the PT at diagnosis was abnormal (prothrombin ratio >1.2) in nine, but in no case was the ratio higher than 1.5. The fibrinogen concentration was 360 ±180 mg/dl (mean ± S.D.) with no value below 150 mg/dl. In fact, the fibrinogen levels were abnormally high in nearly half the patients, perhaps owing to its characteristics as an acute-phase reactant. The absence of consumptive coagulopathy was settled in studies with labeled fibrinogen, in which a normal turnover rate for this protein had been observed.15,16 The fibrin/ogen split products found in some patients with uncomplicated TTP/HUS have been ascribed to an enhanced release of plasminogen activator by the damaged endothelium rather than to an increased cleavage of fibrinogen by thrombin.8 Isolated prolongations of the aPTT have been reported in patients with thrombotic microangiopathy associated with the antiphospholipid syndrome.17
Testing strategies used in the diagnosis of rare inherited bleeding disorders
Published in Expert Review of Hematology, 2023
Laboratory tests of hemostasis can be categorized into screening tests, specific or diagnostic tests, and esoteric assays. Testing is performed on platelet-poor plasma, platelet-rich plasma, or whole blood. Only platelet-poor plasma–based assays can be processed, frozen, and shipped to remote testing sites following guidelines (Table 5) [17,18]. Selected esoteric platelet assays (platelet transmission electron microscopy and platelet surface glycoprotein flow cytometry) can be shipped at ambient temperatures [19,20] but must arrive at the testing laboratory within the established specimen stability limits. Screening tests such as the prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and the platelet function analyzer-100 (PFA-100) are available in most laboratories that perform routine testing. Specific assays such as fibrinogen and d-dimer are also available in these laboratories. More specialized assays, such as mixing studies with normal pooled plasma, and diagnostic assays, such as coagulation factor and inhibitor assays, are restricted to more specialized laboratories. Although there is likely no specific definition of an esoteric assay, most would consider assays such as platelet aggregation assays, platelet flow cytometry assays, and platelet electron microscopy as esoteric assays. These assays require expertise and are restricted to even fewer laboratories.
Antiplatelet drugs and liver fibrosis
Published in Platelets, 2022
Pamela Czajka, Adam Przybyłkowski, Anna Nowak, Marek Postula, Marta Wolska, Dagmara Mirowska-Guzel, Anna Czlonkowska, Ceren Eyileten
It is important to note that the assessment of the hemostatic function in cirrhosis is challenging. The traditional coagulation tests like prothrombin time (PT), the international normalized ratio (INR), and activated partial thromboplastin time (aPTT) are widely used for estimating the risk of bleeding and determination of the best treatment. These tests validate only the procoagulant capacity [89]. In the injured liver production not only pro- but also anticoagulant factors are altered, and assessment of deviations of PT, aPTT, and INR may not provide a reliable prediction for bleeding risk in cirrhotic patients [90–92]. Therefore, as it was reviewed deeply by Sharma et al., to overcome the drawbacks of liver biopsy, several noninvasive techniques have been investigated for the assessment of fibrosis [85,86]. Radiologic techniques and serum-based markers are considered noninvasive methods. Radiologic techniques include ultrasound, magnetic resonance imaging and elastography (transient elastography and magnetic resonance elastography). Serum-based biomarkers of cirrhosis include ARPI, Fibrotest, FIB4 panel, NAFLD fibrosis score, Fibroindex, as well as promising markers, such as hyaluronic acid, N-terminal of serum procollagen III peptide (PIINP), TIMP-1, YKL-40 (chondrex) and ELF score [93–96].
Plasma D-Dimer and Fibrinogen Levels Correlates with Tumor Size and Disease Progression in Nigerian Breast Cancer Patients
Published in Cancer Investigation, 2021
Ogochukwu O. Izuegbuna, Olayide S. Agodirin, Hannah O. Olawumi, Samuel A. Olatoke
Several works of literature have described the close association between cancer and hypercoagulable state (2,4,14,15). Approximately 15–20% of all cancer patients will develop thrombosis during the period of their disease, and the risk of developing thrombosis in breast cancer is about 4.2 times that of the general population (16). Malignancies are known to induce this prothrombotic state (5,17,18). As a result of this close association between cancer and hemostasis, the biomarkers of hemostatic system activation have been seen as potential tools to predict and prognosticate cancer onset and progression. Some of these hemostatic abnormalities include prolonged and shortened PT, partial thromboplastin time (PTT), increased and decreased levels of thrombin, FV, FVIII, FIX, FXI, FXII, fibrinogen, and fibrinogen/fibrin degradation products (2,19).