Splenectomy for Visceral Leishmaniasis Out of an Endemic Region: A Case Report and Literature Review.

Visceral leishmaniasis (also known as kala-azar) is characterized by fever, weight loss, swelling of the spleen and liver, and pancytopenia. If it is not treated, the fatality rate in developing countries can be as high as 100% within 2 years. In a high risk situation for perioperative bleeding due to severe thrombocytopenia/coagulopathy, we present a rare challenge for urgent splenectomy in a patient with previously undiagnosed visceral leishmaniasis.

Comparison of standard fibrinogen measurement methods with fibrin clot firmness assessed by thromboelastometry in patients with cirrhosis.

Background: The Clauss fibrinogen method and thrombin clotting time (TCT) are still routinely used in patients with cirrhosis to define fibrinogen concentration and clotting potential. The thromboelastometric functional fibrinogen FIBTEM assay evaluates the strength of fibrin-based clots in whole blood, providing information on both quantitative deficit and fibrin polymerization disorders.

Objective: To compare these three methods of assessing fibrinogen in patients with cirrhosis of different aetiologies, characterized by impairment in fibrinogen concentration as well as functional aberrance.

Diagnostic relevance of ADAMTS13 activity: evaluation of 28 patients with thrombotic thrombocytopenic purpura - hemolytic uremic syndrome clinical diagnosis.

Introduction: The significance of ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin motif-13) activity for diagnosis and therapy of thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) is still a controversial issue.

Objective: The aim of this report was to analyze the value of ADAMTS13 measurements in the diagnosis of TTP and HUS.

Methods: At presentation, we analyzed patients with idiopathic TTP (n = 18), secondary TTP (n = 4), diarrhea positive HUS (n = 3) and diarrhea negative HUS (n = 3) treated in Belgrade, Serbia from 2004 to 2010.

PFA-100 test in the detection of platelet dysfunction and monitoring DDAVP in a patient with liver cirrhosis undergoing inguinal hernia repair.

Introduction: Hemostatic abnormalities in liver cirrhosis are complex and multifactorial and may predispose to prolonged hemorrhage following invasive procedures. Due to increased perioperative bleeding risks, patients with cirrhosis should undergo elective surgery after making medical preparations. It has been shown that 1-deamino-8-D-arginine vasopressin (DDAVP), desmopressin, can be used as a safe and effective remedy in preventing and treating bleeding in cirrhotics.

Bloodless esophageal replacement in children with corrosive esophageal strictures--report of two cases.

Background: Esophageal replacement is major procedure with high risk for perioperative allogeneic blood transfusion (ABT), especially in pediatric patients due to nutritive deficiency, anemia, small body weight and blood volume. Autologous blood policy is particularly important in female children.

Methods: We present treatment strategy with the aim of avoiding ABT, that have been applied in two female pediatric patients with caustic stricture of thoracic esophagus.

Heparin-induced thrombocytopenia with iliacofemoropopliteal thrombosis in a patient operated for colorectal carcinoma liver metastases.

We report a case of heparin-induced thrombocytopenia thrombosis (HITT) syndrome in a patient prophylactically treated with low molecular weight heparin. A 66-year-old men underwent radiofrequency-assisted partial liver resection for colorectal carcinoma liver metastases a year-and-a-half after he had been operated for rectal cancer. In the postoperative period, patient was prophilactically treated with reviparin sodium.

Different clinical severity of first episodes and recurrences of thrombotic thrombocytopenic purpura.

The clinical course of thrombotic thrombocytopenic purpura (TTP) is characterized by recurrent disease episodes in up to 50% of cases. The clinical presentation and severity of different TTP episodes have not been systematically compared. Laboratory and clinical information from 51 patients with recurrent disease, derived from 136 patients with TTP included in the Milan TTP registry (URL: http://www.

Obstacles in the diagnostics and therapy of heparin-induced thrombocytopenia.

An immune-mediated, severe, acquired prothrombotic disorder, heparin-induced thrombocytopenia type II (HIT II) occurs in 0.5-5% of patients exposed to unfractionated heparin longer than 5-7 days. Arterial and venous thromboses are induced by HIT II in about 35-50% of patients.

The role of rotational thromboelastometry in real time assessment of haemostasis in surgical settings.

Introduction: In the settings of trauma, liver transplantation and major surgery multifactorial coagulopathies are frequently encountered. The treatment of acutely bleeding patients is critically compromised by monitoring with standard available routine coagulation tests. In contrast to conventional tests, rotational thromboelastometry (ROTEM) provides an automated measurement of interactive dynamic haemostatic processes in whole blood starting with initial haemostasis up to and including fibrinolysis at a given time point.

[The use of recombinant activated factor VII in the treatment of gastrointestinal bleeding following acetylsalicylic acid therapy in a surgical patient].

Introduction: Gastrointestinal bleeding is the most important complication associated with acetylsalicylic acid therapy. Patients with preexisting haemostatic disorders are at the higher risk and may experience life-threatening hemorrhagic syndrome. Platelet transfusions and desmopressin administration commonly successfully arrest bleeding.

[The use of recombinant activated factor VII to control haemorrhage following exenteration and massive transfusion in coagulopathic patients].

Introduction: Exentheresis pelvis totalis due to locally advanced pelvic malignancies is an extensive surgical procedure. The operation is commonly associated with anticipated perioperative haemorrhage requiring a large volume of haemoproducts. Sometimes, the intervention can result in unexpected massive and uncontrolled haemorrhage that is frequently a combination of surgical and coagulopathic bleeding.

[Treatment of gastrointestinal hemorrhage manifestation induced by nonsteroidal anti-inflammatory agents]].

Introduction: The risk of upper gastrointestinal tract bleeding in the patients taking NSAID estimates 1% per year. Bleeding stops spontaneously in approximately 80% of all cases. Persistent and repeated bleeding (expecialy during the initial hospitalization) still represent the serious clinical problem.

[Diurnal fluctuations of protein contents and the pH dependence of beta2-microglobulin stability in urine].

Diurnal fluctuations of protein excretion into urine and the effect of urinary pH on the urinary protein concentrations were studied in patients with various kidney diseases. The diurnal kinetics of gamma-immunoglobulin, transferrin, albumin, alpha1-microglobulin, gamma-immunoglobulin light chains, and the retinol-binding protein proved to positively correlate with the diurnal fluctuations of proteinuria and to negatively correlate with urinary pH. Diurnal changes in urinary beta2-microglobulin content did not correlate with those of any other protein.

[Systemic hemostatic drugs].

Understanding the haemostatic changes is crucial in developing strategies for the management of haemorrhage syndroma. In recent years, the revised model of coagulation ("cell based" model) provided a much more authentic description of the coagulation process. Pharmacological intervention, especially desmopresin, antifibrinolytics (synthetics and nature) and increasingly recombinant activated factor VII are being used in prevention and therapeutically to control bleeding of variety etiologies.

[Iron deficiency anemia and its importance in gastroenterology clinical practise].

Iron deficiency anemia (IDA) is a universal problem involving individuals of all ages and both sexes and is a common cause of referral to medical departments. This anemia is one of the most common types of anemia. IDA impairs growth and intellectual development in children and adolescent.

Delayed hemolytic transfusion reaction due to anti-Jk(a).

Background: Kidd antibodies are very heterogeneous and difficult to detect. They have been frequently implicated in delayed hemolytic transfusion reactions (DHTRs).

Case Report: A 64 year old female (6 pregnancies, 2 deliveries, 4 abortions) with none red cell (RBC) transfusions in the history was admitted to hospital due to pneumonia and severe anemia.

[Treatment of 36 cases of thrombotic thrombocytopenic purpura].

Thirty-six patients (pts.) with thrombotic thrombocytopenic purpura (TTP) were treated between May 1990 and May 2003. There were 31 women and 5 men; the average age was 37 years.

[Acute hemolytic transfusion reaction].

Alloogenous blood and/or corresponding haemoproduct transfusion is an efficient and relatively safe supportive treatment. Despite the fact that pre transfusion investigation of both patients and donors ensure high degree of safety of this type of treatment, occurrence of adverse haemotherapy effects is possible and often unpredictable. Acute haemolytic transfusion reaction occur as a consequence of immune conflict between red blood cell membrane agents and specific antibodies present in plasma.

[Acute transfusion-related lung injury].

Transfusion Related Acute Lung Injury (TRALI) is the most serious, potentially lethal, transfusion reaction caused by anti leukocyte antibodies carried passively into recipient's circulation by transfused haemoproduct. It is manifested most frequently within first four hours after transfusion of allogenous haemoproduct containing anti leukocyte antibodies. It is characterized with symptoms and signs of acute respiratory distress syndrome.

[Comparative and quantitative analysis of proteins in the urine peritoneal fluid, separated by gel electrophoresis and stained with silver].

The method for the silver staining of proteins fractionated with SDS electrophoresis is described as a new approach for the complex analysis of biological fluids allowing to obtain the valuable diagnostic information and to determine quantitatively individual proteins in urine and peritoneal fluid, in particular in nephropathologies.

Discontinuities in the temperature function of transmembrane water transport in Chara: relation to ion transport.

The NMR (nuclear magnetic resonance) method of Conlon and Outhred (1972) was used to measure diffusional water permeability of the nodal cells of the green alga Chara gymnophylla. Two local minima at 15 and 30 degreesC of diffusional water permeability (Pd) were observed delimiting a region of low activation energy (Ea around 20 kJ/mol) indicative of an optimal temperature region for membrane transport processes. Above and below this region water transport was of a different type with high Ea (about 70 kJ/mol).

Polarographic investigation of beta 2-microglobulin and ferritin thermal denaturation.

A temperature dependence of the corresponding signals, obtained by differential pulse (d.p.) and alternating current (a.

Isolation and characterization of isoforms of retinol binding protein by isoelectrofocusing.

Retinol binding protein prepared from human urine was fractionated by chromatofocusing into four isoforms: two retinol-containing (holo-) and two retinol-free (apo-) species. The pl values of the isoforms ascertained by isoelectrofocusing with an immobiline pH gradient were: holo(I) 4.79-4.

[Silver staining of proteins separated by polyacrylamide gel electrophoresis: mathematical model].

Silver staining of proteins separated by electrophoresis in the thin layer of polyacrylamide gel can be quantitatively measured when the results are statistically treated. In the mathematical model, the reduction of protein-bound silver ions (crucial silver staining step) is considered to be autocatalytic. According to the model, the reaction rate strongly depends on the stability constant of silver complexes with functional groups of protein amino acids; and the shape of the calibration curve is determined by the ratio of concentration of silver-binding side chain groups to the reciprocal value of the stability constant.

D2O-induced ion channel activation in Characeae at low ionic strength.

Effects of D2O were studied on internodal cells of the freshwater alga Nitellopsis obtusa under plasmalemma perfusion (tonoplast-free cells) with voltage clamp, and on Ca2+ channels isolated from the alga and reconstituted in bilayer lipid membranes (BLM). External application of artificial pond water (APW) with D2O as the solvent to the perfused plasmalemma preparation led to an abrupt drop of membrane resistance (Rm = 0.12 +/- 0.