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6 results

  • Chapter 37 - Hematologic System: Coagulation, Anticoagulation, Antiplatelet, and Thrombolytics

  • Edited by Dharti Patel, Mount Sinai West and Morningside Hospitals, New York, Sang J. Kim, Hospital for Special Surgery, New York, Himani V. Bhatt, Mount Sinai West and Morningside Hospitals, New York, Alopi M. Patel, Rutgers Robert Wood Johnson Medical School, New Jersey
  • Book:
    BASIC Essentials
    Published online:
    21 February 2025
    Print publication:
    13 March 2025, pp 199-208

  • Summary

    This chapter will review the hematologic system and the various medications that an anesthesiologist will encounter. Heparin and warfarin are the most common anticoagulants encountered; however, more recently, new oral and intravenous anticoagulants targeting other factors of the coagulation cascade are being used in their place. As these new medications are developed, identification and knowledge of their characteristics will help guide patient care. Many of these new medications offer particular advantages as compared with the older medications and have been proven to be more effective when treating certain diseases. However, along with these advantages are disadvantages, particularly regarding bleeding and lack of effective reversal agents. Just as there have been advances in anticoagulation, newer antiplatelet agents have also been discovered, introducing a new set of advantages and disadvantages. Although transfusion medicine is discussed in later chapters, we will discuss potential alternatives to blood transfusions as well. Finally, this chapter will also briefly discuss various immunosuppressive agents that one may encounter in the OR setting.

  • Reduction of RBL–2H3 cells degranulation by nitroaromatic compounds from a Bacillus strain associated to the Amazonian sponge Metania reticulata

  • Enrique E. Rozas, Maria A. Mendes, Cláudio A.O. Nascimento, José C.V. Rodrigues, Rodolpho M. Albano, Márcio R. Custódio
  • Journal:
    Journal of the Marine Biological Association of the United Kingdom / Volume 96 / Issue 2 / March 2016
    Published online by Cambridge University Press:
    20 July 2015, pp. 567-572

  • Symbionts in sponges must interact with the host immune system, and this can be mediated by immunomodulators. As the bases of the immune system in sponges resemble those of higher metazoans, it is possible that compounds from this microbiota show similar effects in other phyla. It is also known that several antibiotics, in special macrolides, can modulate many components of the immune response and sponges and their associated microorganisms are a rich source of these compounds. Therefore, we tested the immunosuppressive capacity of antibiotic substances produced by bacterial and fungal strains isolated from the Amazon freshwater sponge Metania reticulata. Fourteen bacterial and six fungal strains were obtained from samples of M. reticulata collected in the Negro River (Amazon Central Basin region), during the dry season. These cultures were monitored for natural antimicrobial activity, and two Bacillus strains (MERETb.761 and MERETb.762) and one fungus (MERETf.010) were selected. One Bacillus strain, MERETb.762, showed strong and specific antibiosis on Staphylococcus aureus and two fractions of its extract inhibited the degranulation of RBL–2H3 cells. The predicted formulas of these fractions were C12H6N4O8 and C25H4N2O6, both corresponding to nitroaromatic compounds.

  • Further studies on the effect of cyclosporin A on the course of Paragonimus infection in rats

  • Yoshihisa Hashiguchi, Yoshisuke Okamura
  • Journal:
    Journal of Helminthology / Volume 63 / Issue 4 / December 1989
    Published online by Cambridge University Press:
    05 June 2009, pp. 328-332

  • Paragonimus ohirai-infected rats were treated with cyclosporin A (CyA) at different times during the course of infection. CyA (5×80 mg/kg) affected the worm recovery, growth and maturation rates of P. ohirai with respect to control values. This tendency was most remarkable in animals treated 15 days and more after infection with CyA (groups B, +15 to +19 days; C, +25 to +29; D, +35 to +39 and E, +45 to +49). In group A (0 to +4), however, the drug did not affect markedly the growth and maturation of worms, although it significantly lowered worm recovery rates. CyA administration also affected normal migration of P. ohirai in the highly susceptible host (rat), when the drug was administered during the peritoneal and/or liver phase of infection. Thus, in this P. ohirai/rat model, CyA significantly reduced worm recovery rates, and affected the growth, maturation and migration of the worms depending on the time of administration.

  • 46 - RHEUMATOID ARTHRITIS AND CEREBROVASCULAR DISEASE

  • from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM
  • Edited by Louis R. Caplan, Julien Bogousslavsky
  • Book:
    Uncommon Causes of Stroke
    Published online:
    06 January 2010
    Print publication:
    09 October 2008, pp 343-346

  • Summary

    Cogan's syndrome is characterized by nonsyphilitic interstitial keratitis, vestibulo-auditory Menière-like symptoms, and, occasionally, systemic manifestations of vasculitis. Although neurologic manifestations are rare, several patients with stroke in the setting of Cogan's syndrome have been reported. The most common and classic ocular manifestation of Cogan's syndrome is bilateral interstitial keratitis. The diagnosis is classically suggested by the association of interstitial keratitis with acute-onset sensorineuronal hearing loss in a patient who has a negative laboratory evaluation for syphilis. Computed tomography (CT) scans may occasionally show intralabyrinthine calcifications, whereas magnetic resonance imaging (MRIs) often show soft tissue obliteration of the membranous labyrinth and may also show multiple lesions of the white matter consistent with cerebral vasculitis. The treatment of Cogan's syndrome varies based on the severity of the clinical manifestations. Due to the presumed autoimmune mechanism with vasculitis, most treatments have included steroids and immunosuppressants.

  • 55 - EPIDERMAL NEVUS SYNDROME

  • from PART V: - SYSTEMIC DISORDERS THAT ALSO INVOLVE THE CEREBROVASCULAR SYSTEM
  • Edited by Louis R. Caplan, Julien Bogousslavsky
  • Book:
    Uncommon Causes of Stroke
    Published online:
    06 January 2010
    Print publication:
    09 October 2008, pp 401-404

  • Summary

    The Churg-Strauss syndrome (CSS) is a type of small-vessel vasculitis that involves the capillaries, arterioles, and venules. There are different clinical and histopathological criteria for the diagnosis of CSS. The clinical criteria of J. G. Lanham and his group for the diagnosis of CSS is a triad consisting of asthma, peak eosinophilia > 1.5 x 109/L, and systemic vasculitis involving two or more extrapulmonary organs. Glucocorticoids remain the main stay of therapy in CSS. Initial therapy with prednisone is usually pulsed (15 mg/kg over 60 minutes repeated at 24-hour intervals for 1-3 days) followed by prednisone 1 mg/kg per day. Involvement of the central nervous system (CNS) is associated with an increased risk for mortality and requires aggressive treatment with steroids and immunosuppressants. The condition should be considered in any patient who has asthma and develops eosinophilia and peripheral and/or CNS signs.