Impact of arterial procedures on coagulation and fibrinolysis : a pilot study

Abstract Objective: The main goal of our study was to assess the impact of vascular procedures on the activity of hemostatic and fibrinolytic pathways. Methods: We enrolled 38 patients with ≥ 45 years old undergoing surgery for abdominal aortic aneurysm or peripheral artery disease under general or regional anesthesia and who were hospitalized at least one night after the procedure. Patients undergoing carotid artery surgery and those who had acute bypass graft thrombosis, cancer, renal failure defined as estimated glomerular filtration rate < 30 ml/min/1.73m2, venous thromboembolism three months prior to surgery, or acute infection were excluded from the study. We measured levels of markers of hemostasis (factor VIII, von Willebrand factor:ristocetin cofactor [vWF:CoR], antithrombin), fibrinolysis (D-dimer, tissue plasminogen activator [tPA], plasmin-antiplasmin complexes), and soluble cluster of differentiation 40 ligand (sCD40L) before and 6-12h after vascular procedure. Results: Significant differences between preoperative and postoperative levels of factor VIII (158.0 vs. 103.3, P<0.001), antithrombin (92.1 vs. 74.8, P<0.001), D-dimer (938.0 vs. 2406.0, P=0.005), tPA (10.1 vs. 12.8, P=0.002), and sCD40L (9092.9 vs. 1249.6, P<0.001) were observed. There were no significant differences between pre- and postoperative levels of vWF:CoR (140.6 vs. 162.8, P=0.17) and plasmin-antiplasmin complexes (749.6 vs. 863.7, P=0.21). Conclusion: Vascular surgery leads to significant alterations in hemostatic and fibrinolytic systems. However, the direction of these changes in both pathways remains unclear and seems to be different depending on the type of surgery. A study utilizing dynamic methods of coagulation and fibrinolysis assessment performed on a larger population is warranted

A clinical profile and factors associated with severity of the disease among Polish patients hospitalized due to COVID-19 — an observational study

Introduction: The coronavirus disease 2019 (COVID-19) is one of the greatest clinical challenges of the last decades. Clinical factors associated with severity of the disease remain unclear. The aim of the study was to characterize Polish patients hospitalized due to COVID-19 and to evaluate potential prognostic factors of severe course of the disease.Material and methods: An observational study was conducted from March to July 2020 in the Pulmonology and Allergology Department of the University Hospital in Kraków, Poland. Consecutive patients with confirmed SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) infection were enrolled, and data about past medical history, signs and symptoms, laboratory results, imaging studies results, in-hospital management and outcomes was prospectively gathered.Results: The study sample comprised 100 patients at the mean age of 59.2 (SD 16.1) years among whom 63 (63.0%) were male. Among them 10 (10.0%) died, 47 (47%) presented respiratory failure, 15 (15.0%) were transferred to the intensive care unit, 17 (17.0%) developed acute kidney injury, 7 (7.0%) had sepsis and 10 (10.0%) were diagnosed with pulmonary embolism. Multivariable analysis revealed age (OR 1.1; 95% CI 1.01–1.15), body mass index (BMI; OR 1.24; 95% CI 1.01–1.53), modified early warning score (MEWS; OR 3.95; 95% CI 1.48–12), the highest d-dimer value (OR 1.73; 95% CI 1.03–2.9) and lactate dehydrogenase (LDH; OR 1.16; 95% CI 1.03–1.3) to be associated with severe course of COVID-19.Conclusion: This observational study showed that almost half of hospitalized patients with COVID-19 developed respiratory failure in the course of the disease. Increasing age, BMI, MEWS, d-dimer value and LDH concentration were associated with the severity of COVID-19

Electrophoretic Deposition of Multi-Walled Carbon Nanotube Coatings on CoCrMo Alloy for Biomedical Applications

Carbon nanotubes are a promising material for use in innovative biomedical solutions due to their unique chemical, mechanical, electrical, and magnetic properties. This work provides a method for the development of ultrasonically assisted electrophoretic deposition of multi-walled carbon nanotubes on a CoCrMo dental alloy. Functionalization of multi-walled carbon nanotubes was carried out by chemical oxidation in a mixture of nitric and sulfuric acids. The modified and unmodified multi-walled carbon nanotubes were anaphoretically deposited on the CoCrMo alloy in an aqueous solution. Chemical composition was studied by Fourier transform infrared spectroscopy. Surface morphology was examined by scanning electron microscopy. The mechanism and kinetics of the electrochemical corrosion of the obtained coatings in artificial saliva at 37 °C were determined using the open-circuit potential method, electrochemical impedance spectroscopy, and anodic polarization curves. The capacitive behavior and high corrosion resistance of the tested electrodes were revealed. It was found that the kinetics of electrochemical corrosion of the CoCrMo electrode significantly decreased in the presence of the functionalized multi-walled carbon nanotube coating. Electrophoretic deposition was shown to be an effective, low-cost, and fast method of producing nanotubes with controlled thickness, homogeneity, and packing density