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عضویت

جستجوی مقالات مرتبط با کلیدواژه "fibrinogen" در نشریات گروه "پزشکی"

  • Seyed Morteza Tayebi, Meraj Mirzaei, Abbass Ghanbari Niaki, Rohoullah Haghshenas Gatabi
    Background

    There have been few investigations into the impact of high-intensity interval training on blood rheology.

    Objectives

    This study aimed to evaluate how high-intensity interval training conducted with different duration affects fibrinogen and plasma viscosity in sedentary young college men.

    Methods

    For this study, 36 healthy male participants were selected and grouped based on their individual characteristics. The groups included a control group (n = 9), a 45-second training group (tr-45; n = 9), a 30-second training group (tr-30; n = 9), and a 15-second training group (tr-15; n = 9). The training regimen comprised six sessions over two weeks, with varying sets (4, 5, 6, 6, 7, 4 respectively) and durations of 15, 30, and 45 seconds for different groups. There was a fixed 4-minute rest interval between each set, with a consistent load of 0.6 on the Wingate cycle ergometer. Blood samples were collected 48 hours before and after the final session to analyze fibrinogen and plasma viscosity levels.

    Results

    There were no significant differences between groups in plasma fibrinogen levels (F3, 32 = 2.303, P = 0.96). However, post-test analysis revealed a significant decrease in plasma fibrinogen in the tr-45 group (P = 0.027) compared to pre-test levels. Plasma viscosity did not significantly change between groups (F3, 32 = 0.651, P = 0.058), but there was a significant interaction between time and group (F3, 40= 4.43, P = 0.009). Post-test analysis showed a significant decrease in plasma viscosity in the tr-45 (P = 0.010), tr-30 (P = 0.002), and tr-15 (P =
    0.003) groups, while it significantly increased in the control group (P = 0.004) compared to pre-test levels.

    Conclusions

    The findings suggest that high-intensity interval training can effectively decrease blood rheology and factors such as fibrinogen and plasma viscosity, with the 45-second HIIT being more efficient. Therefore, incorporating this training into Physical Activity Programs could be beneficial for inactive men.

    Keywords: High Intensity Interval Training, Fibrinogen, Viscosity, Hemorheology, Blood Rheology
  • Jamal Jalili Shahri, Mohammadhadi Saeed Modaghegh, Hamid Tanzadehpanah, Motahare Ebrahimnejad, Hanie Mahaki*
    Background

    The progression of acute limb ischemia (ALI) is being significantly influenced by changes in immune system function. The study aimed to determine the dominant immune cell responses (Th1 or Th2) in ALI patients by measuring serum levels of IL-4, IL-12, and IFN-γ. Previous studies indicate altered cytokine levels in cerebral ischemia, but there is no prior research on these cytokines in ALI patients.

    Methods

    This study involved 34 patients with ALI and 34 healthy controls. Blood samples were analyzed for hematological factors such as erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, red blood cell (RBC) count, platelet (Plt) count, hemoglobin (Hb), and hematocrit (HCT). The levels of serum cytokines IL-4, IL-12, and IFN-γ were measured in both patients and control subjects using enzyme-linked immunosorbent assay (ELISA). The statistical analyses were conducted using SPSS and GraphPad Prism.

    Results

    The results showed that serum levels of IL-4 in ALI patients did not significantly differ from those in control groups. Acute limb ischemia exhibited significantly elevated levels of IL-12 and IFN-γ compared to healthy individuals. In addition, no correlation between the production of cytokines and the hematological parameters was found.

    Conclusion

    Th1 responses are believed to play a role in the pathogenesis of ALI, but further research is needed to fully understand their exact role.

    Keywords: Fibrinogen, ORF-9B Protein, SARS-Cov-2, Serum Albumin
  • Shirin Jalili*, Seyed Mohammadali Hashemi, Jamal Sarvari*
    Background

    Individuals experiencing severe cases of Coronavirus Disease 2019 (COVID-19) exhibited elevated fibrinogen levels and decreased albumin levels, potentially linked to the presence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) proteins. Consequently, our study endeavors to examine the impact of SARS-CoV-2 ORF9b on the expression of fibrinogen and albumin genes within the Hep-G2 cell line.

    Methods

    In this study, the Hep-G2 liver cell line was utilized alongside the plasmid pcDNA3.1 hyg+ containing ORF9b from the SARS-CoV-2 strain originating in Wuhan. Transfection procedures were executed, and the transfected cells were selected utilizing hygromycin B. Validation of ORF9b expression was conducted through SYBR green-based real-time PCR, and the expression of the Fibrinogen α (FGA), Fibrinogen β (FGB), Fibrinogen γ (FGG), and Albumin (ALB) genes was quantified using the same method.

    Results

    The real-time PCR analysis revealed a significant upregulation of fibrinogen genes—α (P=0.03), β (P=0.02), and γ (P=0.029) in Hep-G2 cells containing ORF9b compared to control cells. Furthermore, the findings indicated a markedly lower expression level of albumin in Hep-G2 cells harboring ORF9b compared to the control cells (P=0.028).

    Conclusion

    The findings suggest that SARS-CoV-2 ORF9b could potentially influence the course of SARS-CoV-2 infection by triggering the expression of α, β, and γ fibrinogen gene chains while suppressing the albumin gene. Further investigations are warranted to validate these observations across various SARS-CoV-2 strains exhibiting differing levels of pathogenicity.

    Keywords: Fibrinogen, ORF-9B Protein, SARS-Cov-2, Serum Albumin
  • Atoosa Gharib, Zahra Nematollahi, Behrang Kazemnejad, Ghazal Najafi, Hadi Pashapour, Abdolreza Javadi, Tahmineh Mollasharifi *
    Background
    The role of activation of inflammatory processes in the exacerbation of COVID-19 disease has been fully confirmed. In addition, the occurrence of thromboembolic events in patients with COVID-19 is expected even long after recovery from the disease. However, which factors are essentially prognostic for this disease is still not theoretically agreed upon. What we did in the present study was to evaluate the prognostic role of some inflammatory and coagulation factors in predicting the severity of COVID-19 disease. In this study, the need for ICU admission was considered as a symbol of disease severity.
    Materials and Methods
    Forty-six cases were studied in this cross-sectional study. Patients over 18 years of age with a definitive diagnosis of COVID-19 were assessed in terms of coagulation profiles and inflammatory and cytokine markers. Regarding laboratory data, serum levels of D-dimer, protein S, protein C, FDP, and fibrinogen were measured using an automated coagulation analyzer, and serum levels of interleukin-6 were measured using the ELISA technique.
    Results
    In total, 21 patients (45.7%) were admitted to the ICU due to the severity of the disease. In comparing inflammatory and coagulation factors between the two groups of patients, with and without ICU admission, a significant difference was revealed between fibrinogen (P=0.023), D-dimer (P=0.047), protein C (P=0.001), and protein S level (P=0.014). The decrease in protein C level had the highest value for predicting the severity of the disease and therefore the need for ICU admission.
    Conclusion
    Among various inflammatory and coagulation factors, the role of fibrinogen, D-dimer, protein C, and protein S in predicting the severe form of COVID-19 and the patient's need for ICU admission was confirmed.
    Keywords: COVID-19, Coagulation Factors, Protein C, S, D-Dimer, Fibrinogen, Interleukin 6
  • Alireza Noori*, Seyed Jamal Ashrafi, Zahra Mohammadi, Javad Mohammadnejad Arough, Abdoreza Sheykhmehdi Mesgar
    Introduction

    Bone tissue engineering is one of the emerging strategies that has been developed to restore the bone of the damaged area without provoking an adverse immune reaction. In this context, the tissue engineering scaffold must be as similar as possible to the natural bone tissue. Bone is a nanocomposite material composed of hydroxyapatite and collagen; hence, the development of nanocomposite scaffolds has been viewed as an appropriate choice for bone tissue restoration. In many situations, these composite materials combine a bioactive mineral phase with a biodegradable polymer phase. The current study aimed to create and analyze a new composite scaffold for bone tissue engineering applications employing bioactive glass nanoparticles (nBG) and fibrin.

    Methods

    The nBG used in this study was based on the 70:30: SiO-2CaO system, which was synthesized using the sol-gel method. Scanning electron microscopy (SEM), X-ray crystallography (XRD), and Fourier transform infrared (FTIR) spectroscopy were used to characterize the fabricated nanoparticles. On the other hand, the whole blood was centrifuged twice at 3000×g to separate the plasma from the blood, and during the next steps, fibrinogen and thrombin were separated from the platelet-free plasma. These components were then mixed with nBG to create an injectable composite scaffold. The composites were subjected to physicochemical characterization, such as degradability and clot formation rate, while human osteoblast-like cells (G292- cell line) were used to assess the scaffold's biocompatibility as well as cell proliferation and differentiation using the MTT and alkaline phosphatase activity tests, respectively.

    Results

    In the case of bioactive glass nanoparticles, SEM analysis verified the formation of spherical nanoparticles with a diameter of 50 to 110 nm. XRD analysis showed its non-crystalline nature, and the FTIR spectrum demonstrated the presence of Si-O-Si and O-H functional groups. Investigations on the composite of fibrin and bioactive glass nanoparticles (nBG) revealed that incorporating nBG into the fibrin hydrogel enhances its stability and reduces the degradation rate of the scaffold by approximately %40. In vitro investigations on G292- cells revealed that including nBG in the fibrin hydrogel improves cell viability, cell proliferation by approximately %150, and alkaline phosphatase activity by around %45.

    Conclusion

    Fibrin gel is widely used in bone tissue engineering applications. However, our studies show that when combined with bioactive glass nanoparticles, it is more effective at repairing damaged bones.

    Keywords: Bone, Tissue Engineering, Fibrinogen, Thrombin, Fibrin Bioactive Glass Nanoparticles
  • Abdollah Babaei Tekantapeh, MohammadReza Zolfaghari*, Kamal Khademvatani, Amir Fattahi
    Background

    Cardiovascular diseases are the leading cause of death in developing countries and hemorheological indices are the main factors in developing these diseases.

    Objectives

    The main objective of this study was to investigate the impact of eight weeks of moderate intensity aerobic training combined with supplementation of aqueous extract of Cynodon dactylon L. Pers on hemorheological parameters in non-athletic young men.

    Methods

    A total of 40 young non-athletes (with a mean age of 35.63±6.43 years and a body mass index (BMI) of 23.55±2.13 kg/m2 ) were randomly assigned to one of four groups, including control (C), aerobic exercise (E), the C. dactylon extract (CD), and aerobic exercise+C. dactylon extract (E+CD). Changes in fibrinogen, blood and plasma viscosity, and hematocrit were measured at two stages (baseline and 24 hours after the intervention ended).

    Results

    The blood fibrinogen level in three groups of E, CD, and E+CD showed a significant decline compared to the baseline status (P<0.05). Additionally, there were significant decreases in blood viscosity levels in groups E (P=0.006), CD (P=0.048), and E+CD (P=0.001) after eight weeks of intervention. The plasma viscosity also showed a significant reduction only in group E after eight weeks of intervention (P=0.004). Moreover, hematocrit level significantly decreased in group E+CD (P=0.018).

    Conclusion

    The findings of this study suggest that eight weeks of moderate intensity aerobic exercises alone and in combination with the consumption of the aqueous extract of C. dactylon L. Pers could improve hemorheological indices and reduce the risk of cardiovascular diseases.

    Keywords: Aerobic exercise, Cynodon dactylon rhizome, Fibrinogen, Viscosity, Hematocrit
  • Peyman Kaikhosro Doulatyari, Sedigheh Hosseinpour Delavar *, Mehran Ghahramani, Mohammad Rouzbahani
    Background

     Hemorhological disorders are one of the primary causes of cardiovascular diseases. Accordingly, aerobic and combined exercises can improve hemorhological indicators and reduce cardiovascular complications in high-risk people.

    Objectives

     This study aimed to compare the effects of eight weeks of aerobic and combined exercise on some hemorheological indicators in middle-aged male patients undergoing Coronary Artery Bypass Graft Surgery.

    Methods

     This experimental study was conducted in 2023 on 30 middle-aged men (Age, 57.63 ± 6.38, BMI, 26.61 ± 3.60) undergoing Coronary Artery Bypass Graft Surgery in Kermanshah, Iran, who were divided into aerobic (10 people), combined (10 people), and control (10 people) groups. The intervention groups received selected exercises for eight weeks (24 sessions). Serum hemoglobin, hematocrit, fibrinogen, and erythrocyte sedimentation rate (ESR) were measured before and after the intervention. The parametric paired sample t-test and one-way ANOVA test were used to examine differences at a significance level of P ≤ 0.05.

    Results

     The effect of combined exercises on hemoglobin and hematocrit was significant (P ≤ 0.05), but the amount of reduction in the aerobic group was not significant (P > 0.05). Findings in the fibrinogen and ESR variables showed a significant decrease in both aerobic and combined groups (P ≤ 0.05). There was no significant difference between the effect of eight weeks of aerobic and combined training on the variables of hemoglobin, hematocrit, fibrinogen, and ESR (P > 0.05).

    Conclusions

     Based on the results, aerobic and combined exercises effectively improved the hemorheological indicators and overall conditions of patients who underwent Coronary Artery Bypass Graft Surgery. Therefore, these exercises should be included in the cardiac rehabilitation program as an effective treatment method.

    Keywords: Hemoglobin, Hematocrit, Fibrinogen, ESR, Exercises, Coronary Artery Bypass Graft Surgery
  • سارا خشخاشی مقدم، مصطفی قاسم پور، شهریار نوروزپور، مهرداد مکرم دری، نگار مروت دار، سحر شهبازی، زهره فیضی، ناصر نادری، سیده حورا موسوی واحد، ناهید زیرک*
    مقدمه

    خونریزی بعد زایمان (PPH)، از علل اصلی فوت مادران است. مطالعه حاضر با هدف بررسی ارتباط بین سطوح پایین فیبرینوژن و شدت PPH و اهمیت تجویز کنسانتره فیبرینوژن یا کرایو برای کاهش خونریزی انجام شد.

    روش کار

    این مطالعه کوهورت آینده نگر از سال 98-1396 بر روی 122 نفر از مادران با خونریزی رحمی در 24 ساعت اول بعد از زایمان در مشهد انجام شد. در صورت خونریزی مقاوم و رد علل تروماتیک، میزوپروستول تجویز و نمونه خون در این زمان (زمان صفر) گرفته شد. بیماران با در نظر گرفتن شدت خونریزی از زمان صفر تا 24 ساعت به دو گروه شدید و غیرشدید تقسیم شدند. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماری SPSS (نسخه 16) و آزمون های تی مستقل، من ویتنی تی زوجی، کای اسکوئر و فیشر انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.

    یافته ها

    از 122 مادر، 38 مادر در گروه شدید و 84 مادر در گروه غیرشدید بودند. بیش از 50% مادران زایمان طبیعی داشتند و بین گروه ها از نظر نحوه زایمان تفاوت معنی داری وجود نداشت (883/0=p). سطح فیبرینوژن در زمان صفر بعد زایمان در گروه شدید نسبت به گروه غیرشدید به طور معنی داری کمتر بود (001/0>p). میانگین سطح فیبرینوژن در گروه شدید 8/115±8/274 میلی گرم در دسی لیتر و در گروه غیر شدید 5/78±4/368 میلی گرم در دسی لیتر بود.

    نتیجه گیری

    تجویز زودهنگام فرآورده های حاوی فیبرینوژن می تواند به کاهش خونریزی در PPH کمک کرده و در نتیجه، عوارض ناشی از خونریزی و مداخلات احتمالی کاهش می یابد. در مطالعات آینده همراه افزایش حجم نمونه، نمونه گیری 12 و 24 ساعت بعد زایمان نیز برای کنترل سطح فیبرینوژن پیشنهاد می شود.

    کلید واژگان: بارداری, پس از زایمان, خونریزی, زایمان, فیبرینوژن
    Sara Khashkhashi Moghaddam, Mostafa Ghasempour, Shahriar Norouzpour, Mehrdad Mokarram Dori, Negar Morovatdar, Sahar Shahbazi, Zohreh Feizi, Naser Naderi, Seyyede Houra Mousavi Vahed, Nahid Zirak *
    Introduction

    Postpartum hemorrhage (PPH) is one of the main causes of maternal mortality. The present study was conducted with aim to investigate the relationship between low levels of fibrinogen and the severity of PPH and the importance of administering fibrinogen concentrate or cryo to reduce bleeding.

    Methods

    This prospective cohort study was conducted from 2017 to 2019 on 122 mothers with uterine bleeding in the first 24 hours after delivery in Mashhad. In case of persistent bleeding and rejection of traumatic causes, misoprostol was prescribed, and blood samples were taken at this time (time H0). Patients were divided into severe and non-severe groups by considering the severity of bleeding from H0 to 24 hours. Data were analyzed by SPSS software (version 16) and independent t-test and Mann-Whitney, paired t, Chi-square and Fisher's tests. P<0.05 was considered statistically significant.

    Results

    Of 122 mothers, 38 and 84 were in the severe and non-severe groups, respectively. More than 50% of the mothers had a normal delivery, and there was no significant difference between the two groups in terms of delivery method (p=0.883). Postpartum fibrinogen level in H0 was significantly lower in the severe group compared to the non-severe group (p<0.001). The mean fibrinogen level was 274.8±115.8 mg/dL in the severe and 368.4±78.5 mg/dL in the non-severe groups.

    Conclusion

    Early administration of products containing fibrinogen can help to reduce the amount of bleeding in case of PPH and thus reduce the number of bleeding complications and possible interventions. In future studies along with increasing the sample volume, sampling 12 and 24 hours after delivery is also suggested to control the level of fibrinogen.

    Keywords: Postpartum Period, Hemorrhage, Fibrinogen, pregnancy, Parturition
  • Arzu Irvem *, Selen Zeliha Mart Komurcu, Sule Celik, Derya Erdogan Cakir, Cengiz Aydin, Cemal Kazezo˘glu
    Background

    It is known that the change in coagulation parameters has an effect on mortality and prognosis in COVID-19 patients. The SARS-CoV-2 virus has changed with mutations in the genome of the virus since the beginning of the pandemic, and the resulting variants have been recorded by the World Health Organization. With these variations, the clinical severity of the disease and laboratory parameters have also changed.

    Objectives

    In this study, we examined the changes in D-dimer levels, fibrinogen levels, platelet count (PLT), and mean platelet volume (MPV) between SARS-CoV-2 Alpha (B.1.1.7), Beta (B.1.351) Delta (B.1.617.2), and Omicron (B.1.1.529) variants.

    Methods

    The study was conducted retrospectively on 28 195 adult patients with SARS-CoV-2 infection. At the time of application, data on age, gender, SARS-CoV-2 variant status, D-dimer levels (n = 7090), fibrinogen (n = 5709), PLT (n = 7066), and MPV (n = 8330) were collected. Patients were divided according to alpha, beta, delta, and omicron variants. The changes in variants were examined statistically.

    Results

    The incidence of the delta variant in women was higher than the other variants, followed by alpha and omicron (P = 0.001). The Beta variant was detected at a higher rate in males. The ages of the cases with the Omicron variant were higher than the cases with Alpha, Beta, and Delta variants (P = 0.001, P = 0.001, P = 0.001, and P < 0.01, respectively). In laboratory parameters, D-dimer and fibrinogen levels were detected to be significantly higher in Delta and Omicron variants. PLT and MPV were determined to be lower in delta and omicron than in alpha and beta variants.

    Conclusions

    Examination of the changes in laboratory coagulation parameters according to variants shows that the tendency to clot increases from alpha to omicron.

    Keywords: SARS-CoV-2, Variant, D-Dimer, Fibrinogen, Platelet, MPV
  • Pegah Mohaghegh*, Mohammad Reza Rezvanfar, Farideh Jalali-Mashayekhi, Zahra Amerei, Mohammad Hosseinzadeh
    Background and aims

    The present study aimed to compare the levels of the inflammatory biomarkers of fibrinogen and highsensitivity C-reactive protein (hs-CRP) among type 2 diabetic patients treated with empagliflozin and other hypoglycemic drugs.

    Methods

    This cross-sectional study was performed on 90 patients with type 2 diabetes ( ≥ 30 years) receiving empagliflozin, metformin, and sulfonylurea who were referred to the diabetes clinics affiliated with Arak University of Medical Sciences. After obtaining consent to participate in the study, the patients were categorized into the treatment groups of metformin, metformin + empagliflozin, or metformin + sulfonylurea, and their characteristics and hypoglycemic drugs were recorded in the information checklist. The data were analyzed in SPSS 16 statistical software.

    Results

    The fibrinogen level was minimized in the metformin + empagliflozin group, although the three groups were not significantly different in this regard (P = 0.382). Based on the results, the parameter was higher in the individuals with ischemic heart disease, while a lower level was found among those treated with a lipid-lowering agent. In terms of hs-CRP level, no statistically significant difference was observed among the three groups, although the metformin group had a lower level (P = 0.522).

    Conclusion

    The minimum fibrinogen and hs-CRP levels were related to the metformin + empagliflozin and metformin groups, respectively. Further, several factors such as comorbidities and other consumed drugs could affect the concentration of inflammatory factors. Thus, it is suggested that clinical trials should be conducted in this respect.

    Keywords: Empagliflozin, Fibrinogen, High-sensitivity C-reactive protein, Inflammatory factors, Sodium-dependent glucosecotransporter 2 inhibitors, Type 2 diabetes
  • Zhi-Hong Zheng *, Alireza Shakeri, Dariush Abtahi

    We read with interest the article titled "Prophylactic Fibrinogen Reduces Excessive Bleeding in Total Hip Arthroplasty Surgery: A Randomized Double-blinded Placebo-controlled Trial" authored by Alireza Shakeri et al. with great interest. We commend the authors for their efforts to demonstrate the hemostatic effect of fibrinogen in total hip arthroplasty. However, we are concerned about the lack of clear criteria for postoperative blood transfusion in patients undergoing total hip arthroplasty, a crucial aspect that significantly influences the methodology of this study.

    Keywords: Bleeding, Fibrinogen, prophylaxis, Total hip arthroplasty
  • Alireza Shakeri, Dariush Abtahi *, Marjan Shahmansouri, Alireza Manafi-Rasi
    Objectives
    Excessive blood loss is a critical complication of total hip arthroplasty. We intended to determine whether preoperative fibrinogen administration reduces perioperative bleeding and the need for blood transfusion in total hip arthroplasty surgery.
    Methods
    In 4 months, 178 patients who underwent total hip arthroplasty were randomly assigned equally to intervention and placebo-control groups in a double-blinded, parallel two-arm randomized controlled trial. Both intravenously, 30 min before the start of the surgery, the intervention group received two grams of fibrinogen concentrate dissolved in 100 ml of distilled water. In contrast, the control group received 100 ml of normal saline solution. The amount of postoperative blood loss served as the main result, and the requirement for blood transfusions served as the secondary outcome.
    Results
    In comparison to the placebo, administering fibrinogen concentrate considerably reduced the amount of blood loss (P=0.001) and the requirement for blood transfusions (P=0.004). Patients who got fibrinogen concentrate experienced no side effects. In addition, patients in the fibrinogen group had significantly lower hemoglobin and higher fibrinogen levels in the recovery room and received lesser blood transfusions (P<0.005) than the placebo group.
    Conclusion
    In total hip arthroplasty, fibrinogen concentrate lessens postoperative bleeding and the requirement for blood transfusions. Level of evidence: II
    Keywords: Bleeding, Fibrinogen, prophylaxis, Total hip arthroplasty
  • Shahram Sayadi, Shideh Ariana, Maral Hosseinzadeh, Arezou Ashari, Tannaz Yeganegi, Elham Memari, Ebtehaj Heshmatkhah, Dariush Abtahi *
    Background & Objective

    Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.

    Materials & Methods

    In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.

    Results

    A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.

    Conclusion

    Empiric treatment with fibrinogen concentrate results in reduced blood loss.

    Keywords: Blood Coagulation, Cesarean Section, Erythrocyte Transfusion, Fibrinogen, Postpartum Hemorrhage
  • Maryam Sadat Hosseini, Dariush Abtahi *, Ardeshir Tajbakhsh, Farah Farzaneh, Shahram Sayadi, Nooshin Amjadi, Maral Hosseinzadeh
    Background and Objective
    Delayed diagnosis and treatment of postpartum hemorrhage could result in mortality. Today, there is a strong desire to determine the factors affecting postpartum hemorrhage, particularly fibrinogen levels. This study aimed to investigate the role of plasma fibrinogen levels in postpartum hemorrhage and severe postpartum hemorrhage.
    Methods
    This cross-sectional study was conducted on 169 term pregnant women who were candidates for an elective Cesarean section. Fibrinogen and other coagulating factors were measured before and at the end of the surgery, and twenty-four hours after surgery. Bleeding volume was also measured during and at the end of the surgery, and twenty-four hours after that. The relationship between coagulation factors and the amount of bleeding was examined using statistical tests.
    Results
    Mean plasma fibrinogen levels measured before, at the end of, and 24 hours after surgery were 247.65±91.07 mg/dl, 219.4±75.60 mg/dl, and 223.91±65.44 mg/dl, respectively. Sixty-five patients (38.5%) had postpartum hemorrhage (1000-2000mL) and seven patients (4.1%) had severe postpartum hemorrhage (>2000mL). Of the cases with preoperative fibrinogen levels less than 200mg/dl, 72% had postpartum hemorrhage and 14% had the severe form. There was a strong association between the patient's plasma fibrinogen level with PPH and sPPH (P=0.000).
    Conclusion
    This study showed a strong correlation between plasma fibrinogen levels and postpartum hemorrhage and severe postpartum hemorrhage. In addition, it has been shown that low plasma fibrinogen levels could be a direct prognostic factor for postpartum hemorrhage and severe postpartum hemorrhage. Younger women and preoperative anemia were other strong predictors.
    Keywords: Cesarean Section, Fibrinogen, Postpartum Hemorrhage, Anesthesia
  • Alireza Pournajafian, Faranak Rokhtabnak, Seyed Alireza Seyed Siamdoust, Majid Charousaee *
    Background

    Orthopedic surgeries are frequently complicated with a high amount of intra-operative hemorrhage, and this bleeding has a direct effect on the results of these operations.

    Objectives

    This study evaluated the effect of preoperative administration of fibrinogen on intraoperative bleeding in pelvic surgeries.

    Methods

    This study was a double-blinded, randomized clinical trial. Forty-two patients were randomly divided into two groups of fibrinogen and placebo. Hemoglobin, platelet, and fibrinogen levels were measured in all patients before surgery. In the intervention group, the patients received 1 gr. of fibrinogen after the induction of anesthesia. In the control group, the patients received the same volume of normal saline. All data on bleeding, transfused blood, blood pressure, duration of surgery, hemoglobin, platelet, and fibrinogen levels were recorded during a 24-hour period after surgery.

    Results

    There was no significant difference in terms of age and sex between the groups (P > 0.05). There was no significant difference between hemoglobin, blood transfusion rate, international normalization ratio (INR), prothrombin time (PT), and partial thromboplastin time (PTT) in the two study groups (P> 0.05). Patients’ bleeding rate was significantly lower in the fibrinogen group (1328.57 ± 227.8 mL) than in the placebo group (1610 ± 479.58 mL) (P < 0.05). However, there was no significant difference between serum levels of fibrinogen before and after surgery in both groups (P > 0.05).

    Conclusions

    Although prophylactic injection of fibrinogen did not decrease the rate of blood transfusion to the patients in pelvic surgeries, it resulted in a significant bleeding reduction.

    Keywords: Fibrinogen, Pelvic Surgery, Bleeding
  • Shalini Shukla, Kanchan Kamini, Bhumika Gupta, Shalini Bahadur, Shivani Kalhan, Madhuvan Gupta*
    Introduction

    COVID-19 infection can be complicated by coagulation derangement and a high risk of thromboembolic episodes. Our study aimed to investigate coagulation parameters in COVID-19 patients and their correlation with clinical severity.

    Methods

    We analyzed coagulation parameters PT, APTT, D-Dimer, and Fibrinogen in 98 RT-PCR-confirmed COVID-19 patients admitted to the Government Institute of Medical Sciences, Gautam Buddha Nagar, Uttar Pradesh, India.

    Results

    This study involved 69 males (70.50%), and 29 (29.5%) were females. The mortality rate was 6.12% (n= 06). Forty-six patients (46.94%) had comorbidities. Thirty-four patients had elevated PT, and 7 had high APTT, whereas D-dimer and fibrinogen levels were raised in 68 and 61 patients, respectively. Among all four parameters, D-Dimer levels were significantly associated with disease severity.

    Conclusion

    Derangement of D-dimer levels is significantly associated with disease severity in COVID-19 infection.

    Keywords: APTT, Coagulation, D-Dimer, Fibrinogen, PT, COVID-19
  • امیر دلشاد*، مریم سادات دشتی، سعید اکبری، زهرا عزیزی علویچه
    مقدمه

    یایسگی یک دوره زمانی بالینی مهم است که با تغییرات هورمون تخمدان، علایم وازوموتور و افزایش خطر بیماری های قلبی عروقی CVD  مشخص میشود. یکی از علل اصلی حمله های قلبی تغییرات و عدم تعادل سیستم هموستاز است. کم تحرکی و افزایش سن نیز تاثیرات نامناسبی برسیستم هموستاز دارند. یکی از روش های درمانی که سال ها در درمان بسیاری از بیماری ها کاربرد داشته است، طب ایرانی-اسلامی می باشد. بنابراین در این مطالعه اثر حجامت و تمرینات هوازی بر میزانLDL , HDL  و فیبرینوژن مورد بررسی قرار گرفت.

    مواد و روش ها

    در این پژوهش نیمه تجربی 30 زن یایسه غیرفعال با دامنه سنی 55 تا 65 شرکت کردند. داوطلبین به صورت تصادفی به سه گروه تمرین هوازی ، حجامت و گروه کنترل تقسیم شدند. تمرینات هوازی با شدت 50 تا 75 درصد ضربان قلب ذخیره هفته ای سه جلسه و در طی 6 هفته اجرا شد و گروه حجامت دوبار در هفته دوم و پنجم حجامت شدند. قبل از شروع دوره تمرینی و 48 ساعت پس از اتمام آخرین جلسه تمرین خونگیری جهت اندازه گیری شاخص های فیبرینوژن،LDL, HDL  انجام گرفت. سپس با استفاده از آزمون آنالیز کوواریانس برای مقایسه بین گروهی و مقایسه پیش آزمون و پس آزمون بین گروه ها از آزمون t زوجی درسطح معناداری a<0.05  تحلیل صورت گرفت.

    یافته ها

    تمرین هوازی و حجامت کاهش معنی دار فیبرینوژن (04/0=P) و LDL (001/0=P) و افزایش LDH (003/0=P) نشان دادند. نتایج آزمون T زوجی حاکی از کاهش معنادار فیبرینوژن،LDL  و HDL پس آزمون نسبت به پیش آزمون پس از مداخله بود.

    بحث و نتیجه گیری

    حجامت و فعالیت بدنی هوازی عواملی موثر بر کاهش معنی دار سطح فیبرینوژن و LDL و فیبرینوژن و افزایش HDL بر در زنان یایسه می باشد. با توجه به نتایج احتمالا ورزش میتواند نسبت به حجامت آثار بهتری بر فیبرینوژن و لیپید های خونی که از جمله مهمترین عوامل خطر زای بیماری قلبی- عروقی و تصلب شرایین است، داشته باشد.

    کلید واژگان: حجامت, تمرین هوازی, LDL, LDH, فیبرینوژن
    Amir Delshad*, M.S.Dashti, S.Akbari, Z.Azizi Alavicheh
    Background

    Menopause is a clinically significant period of time characterized by changes in ovarian hormone, vasomotor symptoms, and an increased risk of cardiovascular disease (CVD). One of the main causes of heart attacks is changes and imbalance of the homeostasis system. Sedentary lifestyle and aging also have adverse effects on the homeostasis system. One of the treatment methods that has been used for many years in the treatment of many diseases is Iranian-Islamic medicine. Therefore, in this study, the effect of cupping and aerobic exercise on LDL, HDL and fibrinogen was investigated

    Materials and Methods

    A total of 30 inactive postmenopausal women with an age range of 50 to 65 participated in this quasi-experimental study. Participants were randomly divided into three groups: aerobic exercise, cupping therapy, and control group. Aerobic exercises with an intensity of 50 to 75% of heart rate reserve were performed three times a week for 6 weeks and the cupping group was cupped in the third week. Blood samples were taken to measure fibrinogen, LDL, and HDL before the start of the training period and 48 hours after the end of the last training session. Then, an analysis of covariance was used for intergroup comparisons. Also, the pre- and post-test were analyzed using paired t-test at a significance level of <0.05.

    Results

    Aerobic exercise and cupping showed a significant decrease in fibrinogen (P = 0.04) and LDL (P = 0.001) and an increase in LDH (P = 0.003). Paired t-test results showed a significant decrease in fibrinogen, LDL and HDL post-test compared to pre-intervention post-test.

    Conclusion

    Cupping therapy and aerobic physical activity are effective factors in reducing the levels of fibrinogen and LDL and increasing HDL in postmenopausal women. According to the results, exercise may have better effects on decreasing fibrinogen and blood lipids, as the most important risk factors for cardiovascular disease and atherosclerosis, compared to cupping therapy.

    Keywords: Aerobic Exercise, Cupping, Fibrinogen, LDH, LDL
  • Azim Honarmand, Keivan Bagheri, Alireza Hoghooghy, Kazem Rezaei
    Background

    The present study investigated the plasma level of fibrinogen before and after removing the pump in coronary artery bypass graft (CABG) surgery and its relationship with the need for blood products.

    Materials and Methods

    The present study was performed on 60 patients who were candidates for CABG surgery. The fibrinogen level of these patients was assessed and recorded before surgery and immediately after removing the pump. In addition, their hemoglobin level was recorded before the operation and 2 h after. In addition, the number and type of blood products transfusion were recorded intraoperatively and postoperatively and also at the intensive care unit.

    Results

    Patients’ fibrinogen level after removing the pump with the mean of 130.53 ± 122.01 mg/dl decreased significantly compared to before surgery with the mean of mg/dl 224.95 ± 132.88 mg/dl (P < 0.001). In addition, the prognostic value of fibrinogen after removing the pump in determining the postoperative need of blood transfusion showed that the cut‑off value of fibrinogen was < 196 mg/dl with a sensitivity of 16.82% and specificity of 80%, but it was not statistically significant (area under the curve [95% confidence interval]: 0.519 [0.350–0.689]; P = 0.825).

    Conclusion

    According to the results of the present study, due to significant changes in fibrinogen levels after removing the pump compared to preoperation, it seems that this factor can play an important role in prognosis of the need to postoperative blood transfusion, although the prognostic value and the critical point mentioned in our study was not significant and it is required to do further studies

    Keywords: Blood Transfusion, Coronary Artery Bypass Grafting, fibrinogen
  • Shahin Shirani, Abbas Mohagheghi Dare Ranj, Zeynab Hasansagha *
    Background

    Coronary stenosis and ectasia are cardiovascular diseases characterized by dysfunction of endothelial cells. Studies have shown that impaired blood flow due to inflammation and deposition in the endothelial cell wall can be effective in disease occurrence and progression. Although the etiologies of these diseases have not been identified accurately, it has been shown that inflammation and coagulation can be the main causes in these patients.

    Objectives

    The aim of this study was to evaluate the levels of fibrinogen, Interlukine-17A (IL-17A), and red distribution width (RDW) in patients with coronary artery disease (CAD) and ectasia.

    Methods

    In this study, 140 patients with CAD admitted to Shariati Hospital of Tehran University of Medical Sciences, Iran, were included from from Jun 2020 to October 2021. Based on the severity of CAD, the participants were divided into two equal groups (n = 70 in each) of mild CAD (patients with CAD less than 50%) and multi-vessels CAD (patients with more than 50% stenosis in coronary arteries) according to the number of involved vessels (one, two, or three). Then, 5 cc of peripheral blood was collected from each patient in ethylenediaminetetraacetic acid (EDTA) containing tubes. IL-17A and fibrinogen were measured using enzyme-linked immunosorbent assay (ELISA) kit, and RDW was calculated by cell counter.

    Results

    The mean age of participants was 63.0 ± 11.0 years in the mild group (35% males vs. 65% females) and 60.1 ± 12.1 years in the multi-vessels group (28% males vs. 72% females). The results showed that IL-17A, fibrinogen, and RDW levels in patients with ectasia and multi-vessels group were significantly higher than those in patients without coronary ectasia and mild CAD, respectively (P-value = 0.01 for fibrinogen; P-value = 0.05 for IL-17A; and P-value = 0.03 for RDW).

    Conclusions

    According to our results, identification and evaluation of fibrinogen and IL-17A, along with laboratory indices including RDW can be helpful in diagnosing high-risk individuals. Ectasia can be prevented, and it is possible to increase the patients’ survival through using some preventive and therapeutic strategies.

    Keywords: Coronary Artery Ectasia, Red Distribution Width, Fibrinogen, Interlukine-17A
  • محسن یوسف زاده، بهروز شایسته زاده، سعید سلیمان میگونی، سید محمد صالحی، خلیل کاظم نیا*
    مقدمه

    اختلالات انعقادی از مشکلات نسبتا شایع در بیماران مبتلا به اشکال شدید کووید 19 است. در این مطالعه یک بیمار بستری مبتلا به کووید 19 که دچار هماتوم شکمی شد معرفی می گردد.

    گزارش مورد

    بیمار خانم 46 ساله ای بود که به دلیل کووید 19 در بیمارستان بستری شد. در روز پنجم بستری دچار درد شکم بدون علایم گوارشی شد. در سونوگرافی شکم و لگن یک توده با حجم تقریبی480 سی سی در سمت راست و پایین خط وسط شکم گزارش شد. بیمار با شک به پیچ خوردگی تخمدان تحت عمل جراحی لاپاراتومی قرار گرفت که در حین عمل هماتوم شکمی تشخیص داده شد. این بیمار به طور موفقیت آمیز با خارج کردن هماتوم شکمی و مراقبت های بعد از عمل با حال عمومی خوب مرخص شد.

    بحث و نتیجه گیری

    با توجه به فراوانی اختلالات انعقادی در بیماران مبتلا به کووید 19 و تجویز همزمان داروهای ضد انعقاد در بیماران بستری، خونریزی و هماتوم باید در روند درمانی بیماران مد نظر قرار گیرد.

    کلید واژگان: هماتوم, کووید 19, ویروس کرونا, کواگولوپاتی, ترومبوسیتوپنی, درد شکم, دی -دایمر, فیبرینوژن
    Mohsen Yoosefzadeh, Behruz Shyestezadeh, Saeed Soleiman Meigooni, Seied Mohammad Salehi, Khalil Kazemnia*
    Introduction

    Coagulopathy is a relatively common problem in patients with severe Covid-19. In this study, a hospitalized patient with Covid-19 who developed an abdominal hematoma is introduced.

    Case Report

    The patient was a 46-year-old woman who was hospitalized due to Covid-19. On the fifth day of admission, she developed abdominal pain without gastrointestinal symptoms. Abdominal and pelvic ultrasonography showed a mass with an approximate volume of 480 cc on the right and bottom of the midline of the abdomen. The patient underwent laparotomy with suspected ovarian torsion, which was diagnosed abdominal hematoma during surgery. She was discharged with a good condition after successfully removing hematoma and post operation care.

    Discussion & Conclusion

    Considering the frequency of coagulation disorders in Covid-19 patients and the simultaneous administration of anticoagulants in hospitalized patients, bleeding and hematoma should be considered in the treatment process.

    Keywords: Hematom, COVID-19, Corona virus, Abdominal pain, D-dimer, Fibrinogen, thrombocytopenia, coagolopathy
نکته
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