Search

Aim. To identify and compare the morphological, hemostatic and hemostasiological consequences of intravenous administration of tranexamic acid and fibrin monomer in controlled liver injury against drug-induced thrombocytopathy. Methods. The morphological features of fibrin formation in the area of liver injury after spontaneous bleeding arrest combined with the indicators of blood loss in the animals treated with intravenous placebo, tranexamic acid or fibrin monomer was studied in 69 male rabbits. The effects of these drugs were assessed against thrombocytopathy associated with the combined use of acetylsalicylic acid and clopidogrel. Platelet number and function (adnosine diphosphate-induced aggregation), the data of thromboelastometry and calibrated automated thrombogram, fibrinogen concentration and D-dimer level were considered in the blood test. The feature distribution in the samples was assessed using the ShapiroWilk test. Depending on the distribution, Student's t-test, MannWhitney U test or Wilcoxon signed-rank test were used to test for a significant difference between the features. Differences in mortality rate were established by using Fisher's exact test. The differences were considered statistically significant at p 0.05. Results. A model of thrombocytopathy which showed decreased platelet aggregation function (by 4.5 times), increased blood loss (by 40%), and high mortality (53.9%) was reproduced. Only a small accumulation of thrombotic material was noted on the injured surface of such animals. The use of tranexamic acid led to decreased post-traumatic bleeding (2.5 times) and animal mortality (20%). The latter was provided on the wound surface by increasing the thickness of both thrombotic deposits and fibrin strands. When fibrin monomer was used, the phenomenon of an overcompensated decrease in blood loss (by 6.7 times) accompanied by zero mortality was noted despite a pronounced decrease in platelet aggregation. The maximum increase in the thickness of thrombotic material and fibrin strands was morphologically determined in the injury area compared with other animal groups. Conclusion. Morphological features of traumatic hemostatic effect at the injured area when using tranexamic acid and fibrin monomer have a number of differences despite the similarity of the achieved results in minimizing blood loss.

To evaluate the efficacy of a micronized purified flavonoid fraction in patients with primary venous disease. The study enrolled 31 patients, with varicose veins observed in a total of 47 lower extremities which were divided into 3 groups depending on the CEAP clinical class. The group of class C2 included 19 limbs, with the groups of C3 and C4 comprising 14 limbs each. The patients received a micronized purified flavonoid fraction (Detralex) in a daily dose of 1000 mg for 1 month. The venous function of the lower extremities was examined using venous photoplethysmography before and after the course of pharmacotherapy. Venous refilling time and venous half-refilling time were measured as indicators of total venous reflux. In the overall sample of patients with clinical class C2-C4, a significant increase in venous photoplethysmography parameters was found after the course of administration of the micronized purified flavonoid fraction. Thus, the venous refilling time increased from 15.5 (11; 19) s to 19.3 (13; 25) s, the venous half-refilling time increased from 6.5 (5; 7) s to 7.5 (5; 9) s. At the same time, in the group of patients with clinical class C2 and C3, a significant increase in the venous refilling time was found, and in patients with C4, the increase was not significant. There was an inverse correlation between the increase in venous refilling time after drug exposure and the clinical class of venous insufficiency according to the CEAP, as well as the patient's age. Thus, the administration of the micronized purified flavonoid fraction for 1 month in primary venous disease led to a decrease in the total venous reflux. The effect of the micronized purified flavonoid fraction on the total venous reflux was higher in younger patients and in patients with a lower clinical class of the disease.Целью исследования была оценка эффективности микронизированной очищенной флавоноидной фракции у больных с варикозной болезнью. В исследование включен 31 пациент, варикозное расширение вен наблюдалось на 47 нижних конечностях, которые разделялись на 3 группы в зависимости от клинического класса по СЕАР. В группу с классом С2 вошли 19 конечностей, в группу С3 и группу С4 – по 14 конечностей. Пациенты получали в течение 1 месяца микронизированную очищенную флавоноидную фракцию (Детралекс) в суточной дозе 1000 мг. Венозную функцию нижних конечностей исследовали с помощью венозной фотоплетизмографии до и после курса фармакотерапии. Измеряли время венозного кровенаполнения и время половины венозного кровенаполнения как показателей суммарного венозного рефлюкса. В общей выборке больных с клиническим классом С2–С4 обнаружено значимое увеличение показателей венозной фотоплетизмографии после курса приема препарата. Так, время венозного кровенаполнения повысилось от 15,5 (11; 19) с до 19,3 (13; 25) с, время половины венозного кровенаполнения – от 6,5 (5; 7) с до 7,5 (5; 9) с. При этом в группе пациентов с клиническим классом С2 и С3 зафиксирован значимый прирост времени венозного кровенаполнения, а у пациентов с С4 – прирост был незначимым. Была отмечена корреляционная обратная связь прироста времени венозного кровенаполнения после лекарственного воздействия с клиническим классом венозной недостаточности по СЕАР и с возрастом пациента. Таким образом, назначение микронизированной очищенной флавоноидной фракции в течение 1 месяца при первичном венозном заболевании приводит к уменьшению суммарного венозного рефлюкса. Влияние микронизированной очищенной флавоноидной фракции на суммарный венозный рефлюкс выше у более молодых больных и у пациентов с меньшим клиническим классом заболевания.

In 11 healthy volunteers 21 +/- 3.7 years old was monitored cerebral blood flow (CBF) by transcranial Doppler (TCD) of middle cerebral artery and mean hemodynamic arterial blood pressure (MAP) by continuous non-invasive measurement "beat-to-beat" at normocapnia, hypercapnia and hypocapnia. Hypercapnia was creating by rebreathing, hypocapnia was creating by spontaneous hyperventilation. The partial pressure of CO2 in alveolar air (PetCO2) was monitored by capnograph, embedded in the TCD-analyzer. During hypercapnia the velocity of CBF and PetCO2 were significantly increased already at 10 s, which was considerably earlier than the increase in the MAP (30 s). During hypocapnia velocity CBF and PetCO2 were significantly decreased at 10 s, and MAP was not changed. We have installed the threshold PetCO2 42 (41; 44) mm Hg, below which amplification CBF occurs at a constant MAP and reflects the true cerebrovascular reactivity to CO2.

Bird distribution in the first half of summer was analyzed in the areas of past and present opencast coal mining in the Upper Angara Region. Most species preferred forest habitats even with traces of industrial impact. Artificial water bodies introduced as a result of coal mining increase the diversity of bird species.

Bird distribution in the first half of summer was analyzed in the areas of past and present opencast coal mining in the Upper Angara Region. Most species preferred forest habitats even with traces of industrial impact. Artificial water bodies introduced as a result of coal mining increase the diversity of bird species.