Navegando por Palavras-chave "Antithrombin III"
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- ItemAcesso aberto (Open Access)Effect of estrogen-progestin hormonal replacement therapy on blood coagulation and fibrinolysis in postmenopausal women(Faculdade de Medicina / USP, 2007-01-01) Bonduki, Claudio Emilio [UNIFESP]; Lourenco, Dayse Maria [UNIFESP]; Motta, Eduardo Leme Alves da [UNIFESP]; Soares Júnior, José Maria [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate antithrombin III (AT), thrombin (Fragment 1+2 [F1+2] and thrombin-antithrombin [TAT]) generation markers, as well as other coagulation parameters, such as prothrombin time, partial activated thromboplastin time, thrombin time, fibrinogen, euglobulin lysis time, and platelet count, in postmenopausal women after hormonal therapy. STUDY DESIGN: Forty-five patients who received either 0.625 mg/day unopposed oral conjugated equine estrogen (CEE), 0.625 mg/day oral CEE plus medroxyprogesterone acetate (MP), or 50 µg/day transdermal 17beta-estradiol plus MP, were included. Tests were performed before (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of treatment. AT was determined by an amidolytic method, whereas F1+2 and TAT complex were measured by ELISA. RESULTS: There was a significant reduction in the AT level of patients who received oral CEE plus MP at T3. There was no AT reduction in patients taking either oral CEE alone or transdermal 17beta-estradiol plus MP. F1+2 increased in all patients, but it reached statistical significance only in patients receiving transdermal 17beta-estradiol MP at T3. CONCLUSIONS: The CEE associated with MP treatment may reduce AT levels, whereas unopposed CEE or transdermal 17beta-estradiol plus MP does not change AT. These changes might not be clinically relevant in the general population; however, hormonal replacement therapy may increase the risk of thrombosis in women with congenital or acquired thrombophilia.
- ItemSomente MetadadadosEffect of estrogen-progestin hormonal replacement therapy on plasma antithrombin III of postmenopausal women(Munksgaard Int Publ Ltd, 1998-03-01) Bonduki, Claudio Emilio [UNIFESP]; Lourenço, Dayse Maria [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; Noguti, Maria Aparecida Eiko [UNIFESP]; Motta, Eduardo Leme Alves da [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background. This study was performed to evaluate antithrombin III levels in postmenopausal women receiving hormonal replacement treatment.Methods. It is a prospective randomized study concerning 19 postmenopausal patients, aged 40 to 65 years, who received either continuous daily oral equine conjugated estrogen 0.625 mg (group A, N=10) or daily transdermal 17 beta-estradiol 50 mu g (group B, N=9). Medroxyprogesterone acetate (5 mg/day, 14 days monthly) was given to all patients. Blood samples were obtained before and after 3, 6, 9 and 12 months of treatment. Coagulation tests included Antithrombin III (functional method), prothrombin time, partial activated prothrombin time, thrombin time, factor V, fibrinogen, platelet count and euglobulin lysis time. Friedman analysis of variance and Mann-Whitney test were used for statistical analysis.Results. Antithrombin III level was reduced (p<0.05) in group A but not in group B, although it remained within normal range. No changes were detected in the other coagulation tests.Conclusions. These data suggest that oral conjugated estrogen replacement reduces functional ATIII, whereas transdermal estradiol replacement therapy does not modify it.
- ItemAcesso aberto (Open Access)Hypoprothrombinemia in the compensated form of hepatosplenic schistosomiasis: further studies(Instituto de Medicina Tropical, 1988-08-01) Forones, Nora Manoukian [UNIFESP]; Borges, Durval Rosa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Coagulation abnormality is frequently observed in schistosomiasis patients but its pathophysiology has not been established. We measured, by immunodiffusion. the prothrombin-antigen concentration in 56 individuals; of these 19 with demonstrated compensated form of hepatosplenic schistosomiasis, 17 with cirrhosis and 20 were control subjects. Transaminases, albumin, transthyretin, prothrombin time, antithrombin III, factor VII, and fibrinogen were also evaluated. All parameters were altered in the cirrhotic group but only albumin, prothrombin and antithrombin III levels were altered in the schistosomiasis group. Ninety percent of the patients with cirrhosis and sixty percent of the patients with schistosomiasis had abnormal plasma levels of albumin, transthyretin, prothrombin-antigen, and/or antithrombin III; an impaired hepatic synthesis was responsible for these results. Conversely forty percent of the schistosomiasis patients with normal plasma concentrations of both albumin and transthyretin had decreased mean plasma levels of both prothrombin and antithrombin III. These results suggest that either proth rombin and antithrombin III are more sensitive markers of impaired hepatic synthesis in schistosomiasis than are levels of albumin and transthyretin combined, or a low grade chronic consumption of clotting proteins also occurs. Considering the latter hypothesis it is possible that the thrombin formed would be inhibited by antithrombin III with the complexed thrombin-antithrombin III being cleared by the liver. Consequently the plasma levels of both prothrombin and antithrombin would be decreased, but the level of fibrinogen would be preserved.
- ItemSomente MetadadadosIsolamento e caracterização de espécies moleculares de heparina com diferentes graus de afinidades por antitrombina III: correlação com atividades farmacológicas(Universidade Federal de São Paulo (UNIFESP), 1983) Takahashi, Helio Kiyoshi [UNIFESP]; Dietrich, Carl Peter Von [UNIFESP]
- ItemAcesso aberto (Open Access)Uso de concentrado de antitrombina III em cirróticos com distúrbios de coagulação(Associação Médica Brasileira, 1997-09-01) Ribeiro, A.a.f. [UNIFESP]; Lourenco, Dayse Maria [UNIFESP]; Toledo, Carlos Fischer de [UNIFESP]; Noguti, Maria Aparecida Eiko [UNIFESP]; Borges, D.r. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)BACKGROUND. Patients with severe hepatic failure present acquired deficiency of antithrombin III (ATIII) owing to reduced synthesis associated with intravascular activation of blood coagulation, which may be corrected by ATIII infusion. OBJECTIVE. The aim of this uncontrolled trial was to verify the effect of a standard dose of ATIII concentrate (Kybernin ), that is, 50U/kg of body weight per day, every 2 days, on ATIII levels in patients with severe hepatic failure and hemostatic imbalance. PATIENTS AND METHODS. Six cirrhotic patients were studied: mean age of 44 years (14 to 63 years), who presented at least 2 abnormal coagulation tests (PT > 1.40, APTT > 1.25, Fibrinogen < 1.5g/dL, Platelet count < 80,000/mm³). Mean serum albumin was 2.6g/dL (1.9 to 3.8g/dL). Blood was drawn before infusion, 4h after the first infusion, and just before the next infusion. ATIII levels were measured by amidolytic method. RESULTS. Mean ATIII levels were: initial = 35.8%, 4th h = 56.2%*, 2th d = 48.7%*, 4 d th = 45.7%*, and 8th d = 42.3%. ATIII levels increased significantly after infusion of this standard dose in all patients, although they have not been fully corrected (Friedman test, * p < 0.02), which has been sustained till the 4th day. There was no improvement on the clinical outcome. CONCLUSIONS. These findings suggest that doses of ATIII concentrate higher than 50U/kg/infusion must be administered to patients with severe hepatic failure, to guarantee normal levels of the inhibitor, in order to verify its influence on the hemostatic mechanism.