[Hypercoagulability caused by heroin and amphetamine].
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Biomedical subjects
Publications and source records attributed to E von Kaulla.
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Liver-bypass in the pig and the rat instantly results in a marked increase of fibrinolytic activity. Within 1--2 hours this increase is followed in rats by a normalization. A new increase can be obtained by intravenous Carbachol injection. Removal of organs results to various degrees -- most pronounced after bilateral nephrectomy -- in reduction of control value of fibrinolytic activity before liver-bypass. In rats with adrenalectomy plus splenectomy there is no normalization of liver-bypass-induced increased fibrinolytic activity.
Human urine and urine of various animals contains a powerful procoagulant which converts prothrombin in presence of factors V, VII, X, and phospholipids or thrombocytes into thrombin. In human beings its content of the urine is markedly reduced or totally absent in kidney diseases, but normal in hemophilic patients. Only 0.2 ml urine are required for its assessment. In experimental kidney diseases in rabbits and rats there is an inverse relationship between procoagulant and protein excretion. In the test tube 1 part of urine corrects the clotting of 5-10 parts of hemophilic plasma, even in the presence of very strong coagulation inhibitors.
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A group of 11 menopausal women receiving 1.25 mg. of conjugated estrogens daily had coagulation tests to determine the development of hypercoagulability after taking 5 and 21 tablets. There was no essential change in thrombin generation or fibrinolytic activity as measured by euglobin lysis time. There was a shift toward hypercoagulability in all three parameters of the thrombelastograms. The decrease of the antithrombin III activity was not as pronounced following the administration of conjugated estrogens as had been the change associated with oral contraceptives. Fibrin monomers were observed in some women during the first week of Premarin therapy.
A new continuously recording bedside coagulation screening device is described. The instrument, called an empedance machine, functions by measuring the changing mechanical impedance exerted on a minutely vibrating probe by the progressing fibrin formation of the specimen to be analyzed. The impedance machine works with 0.04-0.4 ml both of whole blood or plasma. During the recordings, the clotting process can be observed in the specimens which are transilluminated. The rugged machine is extremely simple to handle. The two parts which come in contact with blood are disposable. Various examples (recordings) for clinical and experimental applicaton are given and discussed.
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