Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0012739 (disseminated intravascular coagulation)
 8,673 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients are presented in whom cerebral angiography was complicated by bioccipital infarcts resulting in cortical blindness with persisting severe restriction of the visual field (case 1) and persisting cortical blindness (case 2). One patient (case 1) demonstrated a compensated, protracted disseminated intravascular coagulation (Table 1), which disappeared after treatment with phenprocoumon (Marcoumar). The other patient (case 2) demonstrated increasee spontaneous platelet aggregability (Table 2), which was treated sucessfully with acetylsalicylic acid (Magnyl) and dipyridamole (Persantine). We presume that the coagulation disturbances demonstrated after the angiography may be pathogenetic to the complications. We propose that patients with transient cerebral ischemia and apoplexy who are undergoing cerebral angiography should be studied with regard to coagulation before and after the cerebral angiography so that coagulation disturbances demonstrated may be treated before, or corrected after the angiography.
 ...
PMID:Possible increased tendency to thrombosis after cerebral angiography. 45 38

In adult normothermic cats cerebral blood flow was interrupted for 1 hour by clamping the innominate and subclavian arteries. Following ischemia the brains were recirculated with blood, and the coagulation system was investigated by measuring coagulation times and blood content of fibrinogen and platelets. Ischemia induced progressive consumption coagulopathy with an increase in coagulation times and a decrease of platelets and fibrinogen by more than 40%. Coagulopathy was accompanied by a respiratory distress syndrome with a significant increase in the alveolar-arterial carbon dioxide gradient from --3.3 to --13.5 mm Hg. A correlation was found between plasma fibrinogen concentration, cerebral blood flow and electrophysiological function, indicating that a relationship exists between the severity of postischemic coagulopathy and functional recovery following prolonged cerebral ischemia.
 ...
PMID:Coagulopathy following experimental cerebral ischemia. 84 91

Histopathological study on 723 brains from routine necropsies was performed. Ten brains (1.38 percent) were found to have histological lesions of disseminated intravascular coagulation (DIC) with multiple fresh fibrin and/or platelet thrombi in the cerebral microcirculation. Among them, premortem diagnosis was made in only one case, and only two cases also showed evidence of visceral involvement. Microthrombi were found most frequently in the cerebral cortex and hypothalamic region and in the cerebral white matter, brain stem, and cerebellum, in descending order. Neurological symptoms and signs, including lethargy, coma and seizure, were detected in all cases. The abnormal body temperature and/or urinary output observed in most patients appeared to be related to the frequent hypothalamic involvement by DIC. The exclusive or predominant involvement of the brain by multiple microthrombi may be considered as a localized form of DIC. It is probably related to cerebral ischemia since severe acute neuronal ischemic changes also were noted in most brains.
 ...
PMID:Disseminated intravascular coagulation involving the brain: a topographical study. 712 Apr 79

We report on a 3 year old girl with acute promyelocytic leukemia (APL) with cerebral infarction due to disseminated intravascular coagulation (DIC) at initial presentation. She was hospitalized because of unconsciousness and petechiae on the chest wall and extremities. Cerebral ischemia and infarction were found on computed tomography scan and magnetic resonance imaging. Peripheral blood content was hemoglobin 7.3 g/dL, white blood cells 1.0 x 10(3) cells/microL (31% blasts) and platelet count was 12 x 10(3) cells/microL. Fragmented erythrocytes were frequently observed on May-Giemsa stained blood smears. Bone marrow aspirates showed normal cellularity, with 60.4% blasts, containing faggot cells. The blasts were positive for peroxidase. Therapy was begun; however, the patient died 1 week after admission.
 ...
PMID:Cerebral infarction in acute promyelocytic leukemia at initial presentation. 877 58

Viral hepatitis (VH) was diagnosed in 65% of patients with infectious endocarditis (IE) abusing intravenous narcotic drugs. VH caused recurrent course of IE in 8% examinees. The virusological tests of the blood for HBs-antigen or antibodies to viral hepatitis C were positive in 39 patients (group 1) and negative in 21 patients (group 2). VHB, VHC, VHB + VHC were diagnosed in 15, 57 and 28% patients, respectively. An acute course of IE was observed in 72% patients from group 1 and 76% patients from group 2, respectively, subacute course--in 20 and 24%, respectively, recurrent in 8% and 0%, respectively. IE patients with VH often had thrombohemorrhagic complications. DIC syndrome was detected in 25 and 4% patients, hemophthisis--in 33 and 28%, nephritis--in 71 and 48% patients, acute cerebral ischemia--in 7 and 4%, acute myocardial infarction--in 71 and 4%, hypocoagulation--in 53 and 8%, hypercoagulation--in 29 and 50% patients from group 1 and 2, respectively.
 ...
PMID:[Clinical characteristics of endocarditis running with viral hepatitis in intravenous drug abusers]. 1189 18

Abnormalities in blood coagulation, although quite common after traumatic brain injury (TBI), are of unknown significance. The authors review the clinical and pathophysiological features of this phenomenon and emphasize its origin in disseminated intravascular coagulation. This connection provides a possible explanation for much of the cerebral ischemia that accompanies TBI, namely intravascular microthrombosis. The authors' own research findings support this contention and suggest possible therapeutic avenues. A number of compelling studies demonstrate that DIC is a common and important consequence of TBI. In particular, posttraumatic coagulopathy appears to be linked to secondary cerebral injury. Although the extent of this process has yet to be elucidated fully, coagulation abnormalities are evident soon after trauma. This allows early identification of patients likely to suffer secondary complications and provides an opportunity to evaluate promising agents that may mitigate posttraumatic DIC and related pathologies in these patients. This is an area deserving of more intensive research.
 ...
PMID:Coagulopathy in traumatic brain injury. 1617 54

Vancomycin precipitates fibrinogen. The turbidity induced by this vancomycin-fibrinogen interaction is used to establish a simple standardized antigenic assay for plasmatic fibrinogen, the FIATA. 1 mM vancomycin or 2 mM chloramine-T inactivates 50% of fibrinogen in human plasma. In contrast to chloramine-T, vancomycin does not react in NaJ-based photometric assay for chloramines,vancomycin does not inactivate the singlet oxygen-sensible antithrombin III, and the vancomycin action against fibrinogen is not changed in spite of the presence of the 1O2 quenchers methionine or ascorbic acid. The FIATA is performed as follows: to 25 microL plasma 50 microL PBS are added and the absorbance (A) at 405 nm is read. Then 50 microL FIATA-reagent, consisting of 4.4 mM vancomycin in PBS, are added. After 2 minutes (RT) DeltaA is determined and standardized against a plasma pool of 100% of norm (2.8 g/L) fibrinogen. The FIATA is nearly linear up to a fibrinogen concentration of about 150% of norm (4.2 g/L), resulting in a DeltaA of about 600 mA. The lower detection limit is 4% of norm (0.1 g/L). The intra-assay and interessay CV values are < 4%. The normal range of FIATA is 100% +/-20% (x- +/- 1 SD). In = 321 or 344 unselected patient plasmas the FIATA (x- = 130%; SD = 52% or 43%) correlated with the functional fibrinogen assays a) modified Clauss-Method (x- = 4.1 g/L; SD =1.7 g/L) with r = 0.755 and b) FIFTA (x- = 124%; SD = 40%) with r = 0.813. The vancomycin/fibrinogen interaction (binding of about 16 molecules of vancomycin/molecule of fibrinogen) can be used to purify fibrinogen out of plasma. Vancomycin also clouds dysfunctional fibrinogen (fibrinogen in presence of EDTA or chloramine-T)or soluble fibrin. Vancomycin-reacted fibrinogen stimulates tissue type plasminogen activator (t-PA) up to about 20-fold. The experimental data are analyzed by a new significance test: the two foldYates-corrected chi-square comparison against the mean value ofthe control-collective, called the Chi2x - Test. The P < .05 significance barrier calculated with the Chi2x - Test is equivalent to that calculated with the Fisher's Exact Test. The FIATA might be considered an interesting screening test for inactive fibrinogen forms or soluble fibrin, as eg in disseminated intravascular coagulation. Fibrinogen precipitation by vancomycin within the blood vessel might explain why vancomycin has to be infused slowly (< 10 mg/min) to prevent nephrotoxicity. The FIATA is of such a simplicity that the determination of fibrinogen antigen in plasma can be performed anywhere--even outside a hospital--within seconds. Thus, the presented FIATA might contribute to extra hospital testing of patients for assessing their risk for myocardial or cerebral ischemia/infarction.
 ...
PMID:The fibrinogen antigenic turbidimetric assay (FIATA): the X2x test--the corrected chi-square comparison against the control-mean. 1716 98

To evaluate the feasibility of implementing a cardiac assist system in a nonuniversity hospital we analyzed 18 consecutive patients treated with venoarterial membrane oxygenation. The system was used electively in 5/18 (27.8%) patients during high-risk interventions. Thirteen patients (72.2%) were treated in emergency situations. The extracorporal system could be initiated successfully in all patients. Periprocedural complications were hemolysis in 3/18 (16.7%), disseminated intravascular coagulation in 2/18 (11.1%), cerebral ischemia in 1/18 (5.6%), and local infection in 2/18 (11.1%) patients. None of these led to a discontinuation of the therapy. All electively treated patients were successfully weaned from the extracorporeal system. In 9/13 (69.2%) emergency patients the system was removed successfully. The 60-day survival rate of the emergency patients was 53.8% (7/13). Our experience confirms that an innovative extracorporeal circulatory support system can be implemented in a nonuniversity hospital at a tolerable risk and a low complication and high procedural success rate.
...
PMID:Implementing an Innovative Cardiac Assist System in a Nonuniversity Hospital--Feasibility, Complications, and First Results. 2586 5

Vasospasm is one of the most common complications after aneurysmal subarachnoid hemorrhage.Statins have been proven to be effective to reduce the incidence of vasospasm both in experimental subarachnoid hemorrhage and several clinical trials before. This meta-analysis aimed to investigate the efficacy of statins for patients with aneurysmal subarachnoid hemorrhage. We made strict search strategies to select the randomized controlled trial and observational studies published up to December 20(th) 2014. Outcomes of interest were cerebral vasospasm, delayed cerebral ischemia and poor outcome. Data analyses of RCTs and observational studies were made separately. Finally six randomized clinical trial and eight observational studies were included in this meta-analysis. There were in total 1031 patients in six RCTs with 504 patients received statins and 527 patients in placebo group. 561 patients with statins compared with 1579 patients in no statin-use group were finally included in 8 observational studies. Outcomes included in this meta-analysis (cerebral vasospasm, DIC and poor outcome) all indicated no statistical significance between two groups both in RCTs and observational studies. No benefits of statins-use for patients with aneurysmal subarachnoid hemorrhage were observed in both RCTs and observational studies, which was quite different from the results of several previous meta-analysis.
...
PMID:Effect of statins treatment for patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis of observational studies and randomized controlled trials. 2622 Dec 59