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Biomedical subjects

M M Levi

Publications and source records attributed to M M Levi.

13 recordsLinked to original sources
PubMed2006

[Coagulation abnormalities and the dentist].

Defects in the coagulation system increase the risk of excessive bleeding during and after invasive dental procedures. This increased risk of bleeding is irrespective whether the coagulation disorder is inherited or acquired, for example by using anticoagulant medication. However, the cause of the coagulation disorder dictates preventive measures to be taken. Therefore, a careful medical history is crucial to identify and characterize patients with coagulation abnormalities. Recently, the insight in the mechanism of coagulation has increased considerably. This has resulted in specific procedures to adapt the level of coagulation required for specific invasive dental procedures. The dentist must discuss this temporary alteration of the coagulation level with the medical specialist of the patient.

Blood Coagulation↗
PubMed2003

Blood coagulation in anhepatic pigs: effects of treatment with the AMC-bioartificial liver.

The function of a newly devised bioartificial liver (AMC-BAL) based on viable, freshly isolated porcine hepatocytes has been evaluated in anhepatic pigs. The aim of this study was to assess the contribution of BAL treatment on blood coagulation parameters. Pigs were anesthetized and a total hepatectomy was performed (n = 15). The infrahepatic caval vein and the portal vein were connected to the subdiaphragmatic caval vein using a three-way prosthesis. Animals received standard intensive care (control, n= 5), treatment with an empty BAL (device control, n= 5) or with a cell-loaded BAL (BAL-treatment, n= 5) for a period of 24 h starting 24 h after hepatectomy. Coagulation parameters studied concerned prothrombin time (PT), platelet count, the procoagulant system (factors (F)II, FV, FVII, FVIII and fibrinogen), anticoagulant system (AT III), fibrinolytic system (t-PA, PAI-1) as well as markers of coagulation factor activation (TAT complexes, prothrombin fragment F1 + 2). FII, FV, FVII, AT III and fibrinogen rapidly decreased after total hepatectomy in pigs in accordance with the anhepatic state of the animals. FVIII levels were not influenced by the hepatectomy. A mild drop in platelet count was seen in all groups. Treatment of anhepatic pigs with the cell-loaded BAL did not restore PT or clotting factor levels. TAT and F1 + 2 complexes, however, were significantly increased in this group. Levels of t-PA and PAI-1 were not influenced by cell-loaded BAL treatment. Treatment of anhepatic pigs with the AMC-BAL based on freshly isolated porcine hepatocytes does not result in an improved coagulation state due to extensive consumption of clotting factors. However, increased levels of TAT complexes and prothrombin fragments F1 + 2 during treatment of anhepatic pigs indicate synthesis and direct activation of coagulation factors, leading to thrombin generation. This demonstrates that this bioartificial liver is capable of synthesizing coagulation factors.

Animals↗
PubMed2002

[Increased perioperative blood loss during treatment with paroxetine].

A 63-year-old man who took paroxetine for depression developed massive peroperative haemorrhage during a pancreaticoduodenectomy as a result of paroxetine-induced thrombocytopathy. He lost 4 litres of blood. After administration of 8 units of fresh frozen plasma and 2 times 5 units of thrombocyte concentrate, hemostatic control was obtained and the operation could be continued. Paroxetine is a non-tricyclic serotonin reuptake inhibitor prescribed for the treatment of depression. Since this drug also blocks serotonin reuptake in platelets, a clinically significant platelet dysfunction can occur under certain conditions. Because serotonin promotes platelet aggregation, too low an amount of serotonin in the platelets can result in thrombocytopathy. Before major surgery, it is advised to perform extensive clotting tests if there is any hint of haemorrhagic diathesis in the anamnesis. In case of a prolonged bleeding time, paroxetine treatment should be stopped perioperatively.

Antidepressive Agents, Second-Generation↗
PubMed1990

Diagnosis of deep-vein thrombosis using an objective Doppler method.

STUDY OBJECTIVE: To determine the diagnostic criteria (phase I) and to assess the accuracy (phase II) of an objective Doppler-Valsalva pressure method as compared with contrast venography for the diagnosis of acute deep-leg-vein thrombosis in symptomatic outpatients. DESIGN: A two-phase prospective study in consecutive patients. Doppler ultrasound strip-chart recordings and venograms were independently analyzed by experienced observers. SETTING: Referral-based medical clinics at university medical centers. PATIENTS: One hundred and ten (phase I) and one hundred and fifty-five (phase II) patients who had clinically suspected venous thrombosis and were referred by their general practitioners were included. METHODS AND MEASUREMENTS: A normal Doppler test result was defined as a cyclic spontaneous signal (S-signal), a continuous S-signal with a Valsalva pressure of less than 6.5 mm Hg, or an absent S-signal with flow after cessation of the Valsalva maneuver. A continuous S-signal with a Valsalva pressure of 6.5 mm Hg or more or an absent S-signal without flow after cessation of the Valsalva maneuver were defined as abnormal test results. The accuracy indices for proximal vein thrombosis in phase II (155 patients; prevalence, 31%) were sensitivity, 91% (95% CI, 79% to 98%), and specificity, 99% (CI, 97% to 100%). All 3 patients with isolated calf-vein thrombosis had normal Doppler test results. CONCLUSIONS: The objective Doppler method is an accurate, reproducible, and simple method for detection of venous thrombosis in symptomatic outpatients.

Abdomen↗