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Thrombin generation in pathophysiological conditions
Malíková, Ivana
Introduction: Thrombophilic conditions may be accompanied by increased thrombin generation (TG), especially during pregnancy when the increase in thrombin generation results from a series of changes in the haemostatic system. During administration of anticoagulant treatment, it is desirable to reduce the increase in thrombin generation. Aims of the study: The first aim of our study was to compare TG in individuals with a proven factor V Leiden mutation and individuals with elevated levels of factor VIII. Another aim was to compare patients with VTE and also with or without proven FV Leiden mutation that are taking different anticoagulation treatments. The final aim was to assess thrombin generation in pregnant women and their response to LMWH administration during severe thrombophilic conditions. Group of patients and methods: There were included 170 healthy blood donors in the control group, the congenital and acquired thrombophilia group included 44 individuals with FV Leiden mutation and 38 individuals with factor VIII level >150 % without other proven thrombophilia. 347 subjects with VTE taking direct coagulation inhibitors were included in the anticoagulation group. Sixty women with a prophylactic dose of LMWH were included in the group of pregnant women. Kit Technothrombin® TGA RC Low and RC...
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Thrombin generation in pathophysiological conditions
Malíková, Ivana ; Kvasnička, Tomáš (advisor) ; Hirmerová, Jana (referee) ; Úlehlová, Jana (referee)
Introduction: Thrombophilic conditions may be accompanied by increased thrombin generation (TG), especially during pregnancy when the increase in thrombin generation results from a series of changes in the haemostatic system. During administration of anticoagulant treatment, it is desirable to reduce the increase in thrombin generation. Aims of the study: The first aim of our study was to compare TG in individuals with a proven factor V Leiden mutation and individuals with elevated levels of factor VIII. Another aim was to compare patients with VTE and also with or without proven FV Leiden mutation that are taking different anticoagulation treatments. The final aim was to assess thrombin generation in pregnant women and their response to LMWH administration during severe thrombophilic conditions. Group of patients and methods: There were included 170 healthy blood donors in the control group, the congenital and acquired thrombophilia group included 44 individuals with FV Leiden mutation and 38 individuals with factor VIII level >150 % without other proven thrombophilia. 347 subjects with VTE taking direct coagulation inhibitors were included in the anticoagulation group. Sixty women with a prophylactic dose of LMWH were included in the group of pregnant women. Kit Technothrombin® TGA RC Low and RC...
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Thrombophilia and thrombotic complications in severe septic patients
Zenáhlíková, Zuzana ; Kvasnička, Jan (advisor) ; Maruna, Pavel (referee) ; Malý, Jaroslav (referee)
Introduction: Thrombotic events are among the most serious complications of sepsis and also the most frequent causes of morbidity and mortality in patients with sepsis. Currently, the administration of low molecular weight heparins (LMWH) is recommended in patients with severe sepsis for prophylaxis of these complications. However, this prophylaxis often fails. Objectives of the study: One of the objectives of our study was to examine changes in haemostasis in relation to the inflammatory response during 15 days of severe sepsis. The next objective was to determine whether a prophylactic inhibition of F Xa in the range from 0.2 to 0.4 IU/mL is achieved in these patients, if they receive the recommended prophylaxis with LMWH. We also recorded the dynamics of changes in the F Xa inhibition during the entire study period. Moreover, we tried to identify the factors that may affect the antithrombotic efficacy of the subcutaneously administered enoxaparin. Patient population and methods: A total of 35 ICU patients meeting the criteria of severe sepsis were enrolled in the study. Only 16 of these patients could be followed throughout the entire 15-day period. Patients were treated according to the current guidelines, including LMWH prophylaxis; enoxaparin (40 mg sc per day) was used in this study....
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Hyperkoagulační stavy v graviditě a jejich komplikace
KABELOVÁ, Kristýna
Hypercoagulable states occur when the process of hemostasis is disturbed. It manifests as a deep vein thrombosis or a pulmonary embolism. It is also one of the most common cardiovascular diseases. There are two factors- genetic and acquired. Inherent factors involve coagulation inhibitor deficiency, prothrombin gene mutation and activated protein C resistance. Acquired factors include antiphospolipid syndrome, pregnancy, overweight etc. The analytic part of the thesis is focused on the effect of a low molecular weight heparin. It was shown in many theses that the LMWH could have a negative impact on a parturition complications or a week of parturition, a birth weight. The results of statistical analysis show that there is a coherence between the week of parturition and the type of parturition. What is more, the anticoagulation drug therapy shows a positive effect on the week of parturion. The data used in the thesis originate in laboratory information management system of Clinical Haematology ward in the hospital Nemocnice České Budějovice a.s.
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The role of nurses in the application of low molecular weight heparin
Kubátová, Lenka ; Křivková, Jana (advisor) ; Tomová, Šárka (referee)
The bachelor thesis "Role of a nurse in application of a low-molecular-weight heparin" focuses on the topic of application of a low-molecular-weight heparin. The aim of the research was to explore the correct technique of a subcutaneous application of a low- molecular-weight heparin and assess the role of nurses in educating patients about the application. The theoretical section provides a basic overview of the low-molecular-weight heparin and explains the principles of antithrombotic therapy. The research section was implemented using a quantitative research technique, interviews using a structured questionnaire. The survey included 130 respondents working at standard surgical, orthopaedic, internal medicine wards and intensive care unit in the University Hospital Motol. The results showed nursing problems in the technique of application of low-molecular-weight heparin. The same number of respondents report a correct application angle (62 %) and do not massage the injection site (63 %). One third of respondents remove air bubbles from a syringe, only 58 % of respondents keep the skin pinch throughout the application. The survey proved that nurses from standard wards and nurses with a University degree apply the correct technique of a low-molecular-weight heparin application better than nurses...
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Thrombophilia and thrombotic complications in severe septic patients
Zenáhlíková, Zuzana ; Kvasnička, Jan (advisor) ; Maruna, Pavel (referee) ; Malý, Jaroslav (referee)
Introduction: Thrombotic events are among the most serious complications of sepsis and also the most frequent causes of morbidity and mortality in patients with sepsis. Currently, the administration of low molecular weight heparins (LMWH) is recommended in patients with severe sepsis for prophylaxis of these complications. However, this prophylaxis often fails. Objectives of the study: One of the objectives of our study was to examine changes in haemostasis in relation to the inflammatory response during 15 days of severe sepsis. The next objective was to determine whether a prophylactic inhibition of F Xa in the range from 0.2 to 0.4 IU/mL is achieved in these patients, if they receive the recommended prophylaxis with LMWH. We also recorded the dynamics of changes in the F Xa inhibition during the entire study period. Moreover, we tried to identify the factors that may affect the antithrombotic efficacy of the subcutaneously administered enoxaparin. Patient population and methods: A total of 35 ICU patients meeting the criteria of severe sepsis were enrolled in the study. Only 16 of these patients could be followed throughout the entire 15-day period. Patients were treated according to the current guidelines, including LMWH prophylaxis; enoxaparin (40 mg sc per day) was used in this study....
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Hyperkoagulační stavy v graviditě, vliv nízkomolekulárního heparinu
KABELOVÁ, Kristýna
Hypercoagulable states cause thromboembolic disease which includes deep vein thrombosis and pulmonary embolism. It's one of the most common cardiovascular diseases. It ocurrs due to genetic and acquired factors. Congenital factors include coagulation inhibitor deficiency, prothrombin gene mutation, activated protein C resistence etc. Acquired factors include use of oral contraceptives, imobility, pregnancy etc. The analytic part of the thesis is focused on level of D-dimer of pregnant women depending on congenital hypercoagulable states and anticoagulant therapy. These women were patient of Clinical hematology clinic in the České Budějovice hospital a.s. in 2016.
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