Coagulation and fibrinolysis were determined in 67 Indonesian women admitted to the University Hospitals for delivery in Medan. They were diagnosed to be at term gestation (mean 39.3 +/- 1.1 weeks) with moderate and severe preeclampsia (n=32) and in labor, and 8 had preterm labor (gestation mean 33.5 +/- 2.6 weeks). Twenty-seven normal pregnant women in labor (gestation mean 39.7 +/- 1.0 weeks) served as controls. Cord blood from 23 neonates from normal pregnancy and 31 neonates from preeclampsia was also evaluated. Preeclamptic women in labor showed further enhanced coagulation activation (F(1+2)) with raised urokinase-like plasminogen activator (u-PA) activity and reduced plasminogen activator inhibitor-2 (PAI-2) levels. In preterm preeclampsia, significantly reduced antithrombin III (ATIII) and PAI-2 levels with further elevated tissue-type PA (t-PA) antigen and plasminogen activator inhibitor-1 (PAI-1) antigen were seen compared to normal pregnancy. These would suggest a state of enhanced thrombin generation with elevated fibrinolytic/inhibitor proteins in preterm preeclampsia. The reduced PAI-2 levels seen in preeclampsia have been suggested to be associated with reduced placental function. Neonates born to mothers of either normal pregnancy or preeclampsia at term showed similar hemostatic changes with reduced fibrinogen, ATIII, t-PA, u-PA antigen, PAI-1 levels, and coagulation activation compared to their respective maternal plasma levels. No significant differences in hemostatic parameters studied between the neonates of both cohorts were seen, and this would suggest that the neonates were protected from the adverse effects of preeclampsia and their hemostatic system was physiologically balanced.
Background: Someone who approves the PRC must have been transfused no more than 24 hours after the creation of the PRC; some also apply 3 days. But there are also those that apply up to 1 week. PRC is still feasible to be transfused immediately by seeing changes that occur in the value of hemoglobin (Hb), hematocrit (Ht), and plasma needed when storing. Methods: 30 whole blood bags (WB) were taken for this study. The WB is at the request of the doctor for the manufacture of PRC. The blood bag is rotated at a speed of 4,000 RPM for 15 minutes. From the PRC, 3 cc of blood was taken on 1,3,5,7 days for hemoglobin (Hb), hematocrit (Ht), and glucose plasma. Data were analyzed Latar Belakang: Seseorang yang menyetujui PRC harus sudah ditranfusikan tidak lebih dari 24 jam setelah pembuatan PRC; namun terdapat juga yang menggunakannya dalam 3 hari. Di samping itu, masih terdapat beberapa kasus yang memberlakukan sampai 1 minggu. Sehingga belum ada kepastian berapa hari pasca pembuatan PRC masih layak untuk segera ditransfusikan dengan melihat perubahan yang terjadi pada nilai hemoglobin (Hb), hematokrit (Ht), dan plasma glukosa menurut waktu simpan Metode: 30 kantong whole blood (WB) diambil untuk penelitian ini. WB tersebut adalah atas permintaan dari dokter untuk pembuatan PRC. Kantong darah diputar dengan kecepatan 4.000 RPM selama 15 menit. Dari PRC tersebut diambil 3 cc darah pada hari 1,3,5,7 untuk pemeriksaan hemoglobin(Hb), hematokrit (Ht), dan plasma glukosa. Data di analisis dengan piranti lunak SPSS versi using SPSS version 21 software for Windows. Results: After 1-day taking 3 cc of blood, PRC was stored at 4 ° C, and then 3cc was taken also on days 3, 5, 7. The results showed that hemoglobin (Hb), hematocrit (Ht) increased from day 1 until day 7 but not significant (P> 0.05), plasma plasma showed a decrease from day 1 to day 7 and significant (P <0.001) but the value was still within normal limits. Correlation value between Hb and PRC retention time; r = 0.127, Ht with the shelf life of PRC, r = 0.160, plasma glucose with the length of time the PRC is stored; r =-0,844. Conclusion: PRC stored for 7 days is still feasible to use. There was a decrease in plasma glucose but still within normal limits. 21 untuk Windows. Hasil: Setelah hari-1 pengambilan 3 cc darah, PRC disimpan pada 4 ° C, dan selanjutnya diambil 3cc juga pada hari 3, 5, 7. Hasil penelitian menunjukkan bahwa hemoglobin (Hb), hematokrit (Ht) meningkat dari hari ke-1 sampai hari ke-7 namun tidak signifikan (P>0,05), pada plasma glukosa menunjukkan penurunan dari hari-1 sampai hari-7 dan siginifikan (P <0,001) tetapi nilainya masih dalam batas normal. Nilai korelasi antara Hb dengan lama simpan PRC; r = 0,127, Ht dengan lama simpan PRC, r =0,160, plasma glukosa dengan lama simpan PRC; r =-0,844. Kesimpulan: PRC yang disimpan selama 7 hari masih layak dipergunakan. Terjadi penurunan pada plasma glukosa namun masih dalam batas normal.
The increasing level of hemostatic parameters and tumor markers were associated with cancer progression and poor prognosis, particularly in NSCLC. The objective of this study is to determine whether there was a correlation between hemostatic parameters and mortality rate in patients with NSCLC. This was a prospective analytical study with a pretest-posttest design which included 41 patients with diagnosis of NSCLC. Plasma levels of PT, APTT, TT, D-dimer, and fibrinogen were measured before initiation of chemotherapy and remeasured after 4 cycles or 6 cycles of chemotherapy, based on the clinical condition of patients. Then, patients were followed up for 1 year to evaluate the mortality rate. The majority of subjects were male (85.4%) with adenocarcinoma (75.6%). There was no significant difference in mean between adenocarcinoma and squamous cell carcinoma (P>0.05). Most patients died after one month of follow up (61%). The parameters which could predict high mortality rate in NSCLC were prolonged PT and the increased of D-dimer with RR>1, although they had not significant in statistical analysis (P>0.05). There is no correlation between hemostatic parameters and mortality rate in patients with NSCLC.
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