Rezistentnost trombocita blesnika sa solidnim tumorima na anatiagregacijski učnak acetilsalicilne kiseline

The anti-aggregating effect of acetylsalicylic acid (ASA 100 mg/day and 200 mg/day) was monitored in platelets of 351 solid tumor patients. As ASA increases the aggregation time, its anti-aggregating effect plays an important role in the prevention of thrombosis. Measurements were performed using the Siemens PFA 100 aggregometer with a collagen/EPI test cartridge. The mean age of patients was 64.33 ± 11.67 years. Among them, there were 74 (21.08%) male and 277 (78.91%) female patients suffering from head and neck tumors - 34 pts (9.69% ), breast cancer - 222 pts (63.2%), lung cancer - 4 pts (1.14%), abdominal cancer - 54 pts (15.4% ), urinary - 4 pts (1.14%), and genital tract cancer - 33 pts (9.4% ). Aggregation levels >160 seconds show the ASA effect on circulating platelets. The anti-aggregating effect of ASA 100 mg/day reported in 142 (40%) pts was absent in 209 (60%) pts. The mean anti-aggregating effect of ASA 100 mg/day for male and female patients was 169.29 ± 79.54 and 168.51 ± 69.71 seconds, respectively. No statistically significant difference was found between the male and female platelet aggregation results (p = 0.759). Interindividual variability in aggregation profiles was observed with the coefficient of variation CV = 41-47%. From the group not responding to ASA 100 mg/day, 40 patients were singled out to receive ASA 200 mg/day; of them 17 (42%) were responsive, and 23 (58%) patients were not responsive. No statistically significant difference was found between the two measurements carried out on samples from the same 38 patients with a 1-month interval (p = 0.063) to show the intraindividual stability of platelet aggregation. Whereas the antiaggregating effect of both ASA 100 mg/day and 200 mg/day has been shown in only 40% patients, dose tailoring based on the individual aggregation result is recommended.Praćen je antiagregacijski učinak acetilsalicilne kiseline (ASK 100 mg/dan i 200 mg/dan) na trombocite 351 bolesnika sa solidnim tumorima. ASK produžuje vrijeme agregacije; pa je njen antiagregacijski učinak važan u prevenciji tromboze. Korišten je agregometar Siemens PFA-100 s kolagenskim/epinefrinskim uloškom. Prosječna dob bolesnika bila je 64;33 ± 11;67 godina. Muškaraca je bilo 74 (21;08%); a žena 277 (78;91%). Bolesnici su bolovali od tumora glave i vrata 34 (9;69% ); dojke 222 (63;2% ); pluća 4 (1;14%); trbuha 54 (15;4% ); mokraćnog 4 (1;14%) i spolnog sustava 33 (9;4%). Vrijednosti agregacije >160 sekundi pokazuju djelovanje ASK na trombocite. Antiagregacijski učinak ASK 100 mg/dan bio je u 142 (40%) bolesnika; a nije ga bilo u 209 (60%). Prosječni antiagregacijski učinak ASK 100mg/dan za muškarce bio je 169;29 ± 79;54 sekundi; a za žene 168;51 ± 69;71 sekundi. Statistički značajne agregacijske razlike izme|u rezultata muškaraca i žena nije bilo (p = 0;759). Interindividualna varijabilnost agregacije pokazuje koeficijent varijabilnosti CV = 41-47%. Iz skupine koja nije reagirala na ASK 100 mg/dan izdvojeno je 40 bolesnika i liječeno primjenom ASK 200 mg/dan. Reagiralo je 17 (42%); a nije 23 (58%). Nije bilo statistički značajne razlike dvaju mjerenja uzoraka 38 istih osoba; u razmaku od mjesec dana (p =0;063); što pokazuje intraindividualnu stabilnost agregacije. S obzirom na to da se samo u 40% osoba uočava antiagregacijski učinak ASK 100 mg/dan i 200 mg/dan; preporučuje se individualno doziranje oslonjeno na agregacijski nalaz

Rezistentnost trombocita blesnika sa solidnim tumorima na anatiagregacijski učnak acetilsalicilne kiseline

The anti-aggregating effect of acetylsalicylic acid (ASA 100 mg/day and 200 mg/day) was monitored in platelets of 351 solid tumor patients. As ASA increases the aggregation time, its anti-aggregating effect plays an important role in the prevention of thrombosis. Measurements were performed using the Siemens PFA 100 aggregometer with a collagen/EPI test cartridge. The mean age of patients was 64.33 ± 11.67 years. Among them, there were 74 (21.08%) male and 277 (78.91%) female patients suffering from head and neck tumors - 34 pts (9.69% ), breast cancer - 222 pts (63.2%), lung cancer - 4 pts (1.14%), abdominal cancer - 54 pts (15.4% ), urinary - 4 pts (1.14%), and genital tract cancer - 33 pts (9.4% ). Aggregation levels >160 seconds show the ASA effect on circulating platelets. The anti-aggregating effect of ASA 100 mg/day reported in 142 (40%) pts was absent in 209 (60%) pts. The mean anti-aggregating effect of ASA 100 mg/day for male and female patients was 169.29 ± 79.54 and 168.51 ± 69.71 seconds, respectively. No statistically significant difference was found between the male and female platelet aggregation results (p = 0.759). Interindividual variability in aggregation profiles was observed with the coefficient of variation CV = 41-47%. From the group not responding to ASA 100 mg/day, 40 patients were singled out to receive ASA 200 mg/day; of them 17 (42%) were responsive, and 23 (58%) patients were not responsive. No statistically significant difference was found between the two measurements carried out on samples from the same 38 patients with a 1-month interval (p = 0.063) to show the intraindividual stability of platelet aggregation. Whereas the antiaggregating effect of both ASA 100 mg/day and 200 mg/day has been shown in only 40% patients, dose tailoring based on the individual aggregation result is recommended.Praćen je antiagregacijski učinak acetilsalicilne kiseline (ASK 100 mg/dan i 200 mg/dan) na trombocite 351 bolesnika sa solidnim tumorima. ASK produžuje vrijeme agregacije; pa je njen antiagregacijski učinak važan u prevenciji tromboze. Korišten je agregometar Siemens PFA-100 s kolagenskim/epinefrinskim uloškom. Prosječna dob bolesnika bila je 64;33 ± 11;67 godina. Muškaraca je bilo 74 (21;08%); a žena 277 (78;91%). Bolesnici su bolovali od tumora glave i vrata 34 (9;69% ); dojke 222 (63;2% ); pluća 4 (1;14%); trbuha 54 (15;4% ); mokraćnog 4 (1;14%) i spolnog sustava 33 (9;4%). Vrijednosti agregacije >160 sekundi pokazuju djelovanje ASK na trombocite. Antiagregacijski učinak ASK 100 mg/dan bio je u 142 (40%) bolesnika; a nije ga bilo u 209 (60%). Prosječni antiagregacijski učinak ASK 100mg/dan za muškarce bio je 169;29 ± 79;54 sekundi; a za žene 168;51 ± 69;71 sekundi. Statistički značajne agregacijske razlike izme|u rezultata muškaraca i žena nije bilo (p = 0;759). Interindividualna varijabilnost agregacije pokazuje koeficijent varijabilnosti CV = 41-47%. Iz skupine koja nije reagirala na ASK 100 mg/dan izdvojeno je 40 bolesnika i liječeno primjenom ASK 200 mg/dan. Reagiralo je 17 (42%); a nije 23 (58%). Nije bilo statistički značajne razlike dvaju mjerenja uzoraka 38 istih osoba; u razmaku od mjesec dana (p =0;063); što pokazuje intraindividualnu stabilnost agregacije. S obzirom na to da se samo u 40% osoba uočava antiagregacijski učinak ASK 100 mg/dan i 200 mg/dan; preporučuje se individualno doziranje oslonjeno na agregacijski nalaz

Trombocitna rezistencija na klopidogrelski antiagregacijski učinaku bolesnika sa solidnim tumorima

The anti-aggregating effect of clopidogrel (75 mg/day) on platelet function was monitored in 33 solid tumor patients. Clopidogrel irreversibly blocks the platelet P2Y12 receptor and inhibits platelet aggregation induced by adenosine diphosphate (ADP). Whole blood aggregation was measured using a Siemens PFA-100 aggregometer including the Innovance PFA P2Y cartridge. The mean age of patients was 62 ± 13 years. Among them, there were 19 (58%) males and 14 (42%) females. The values of platelet aggregation >106 seconds and 106 sekunda pokazala je klopidogrelski antiagregacijski učinak u 22 (67%) bolesnika; a vrijednost <106 sekunda uočena je u 11 (33%) bolesnika koji nisu reagirali. Prosječni klopidogrelski antiagregacijski učinak bio je 219 ± 110 sekunda. Agregacijskih razlika između muškaraca i žena nije bilo (p=0;784). Interindividualna agregacijska varijacija bila je 50%. Nije bilo statistički značajne razlike između dvaju mjerenja 7 uzoraka istih osoba u razmaku od mjesec ili više dana; što pokazuje intraindividualnu stabilnost klopidogrelskog djelovanja na trombocitnu agregaciju (p=1;000)

Koncentracija feritina u serumu kod bolesnika sa solidinim tumorima

Ferritin is a positive acute phase reactant. It is produced and secreted by various cells such as hepatocytes, macrophages and cancer cells. This was a retrospective study which included 46 patients with solid tumors who were tested for ferritin level in plasma. The measured value of the ferritin concentration in plasma of patients was in the range from 5.98 to 850.78 μg/L, and the average measured value was 174.62 μg/L. For the control group, we also included 46 subjects. The measured value of ferritin in the control group was in the range from 5.94 to 351.54 μg/Ll, and the average measured value was 63.17 μg/L. There is a statistically significant difference between the two groups. Our data shows that the highest level of ferritin was measured in patient with breast cancer. By many studies done until now it is shown that iron metabolism is dysregulated in cancer, and that changes occur in both intracellular and extracellular ferritin.Feritin je reaktant akutne faze. Proizvode ga i luče različite stanice, jetrene, makrofagi i neoplastične stanice. U ovoj retrospektivnoj studiji obrađeni su podaci 46 bolesnika sa solidnim tumorima kojima je određena koncentracija feritina u serumu. Koncentracija feritina kod bolesnika kretela se u rasponu od 5,98 do 850,78 g / L, a prosječna izmjerena vrijednost je 174,62 g / L. Kontrolan skupina je 46 zdravih osoba. Izmjerena vrijednost feritina u kontrolnoj skupini kretala se u rasponu 5,94 do 351,54 g / Ll, a prosječna izmjerena vrijednost je 63.17 g / L. Postoji statistički značajna razlika između dvije skupine. Naši podaci pokazuju da je najviša razina feritina izmjerena kod bolesnice s rakom dojke. Mnoge studije učinjene do sada pokazale su da postoji poremećaj metabolizma željeza kod malignih stanja, te da dolazi do promjena i unutarstaničnog i izvanstaničnog feritina

Recidiv duboke venske tromboze tijekom terapije kumarinima u bolesnika s karcinomom -prikaz slučaja

Cancer patients have a four-fold increased risk of developing venous thromboembolism (VTE), relative to the general population. Affecting about 15 % of patients with cancer, it is presenting a great challenge for prophylaxis and treatment. The standard treatment for acute venous thromboembolism consists of initial therapy with low-molecular-weight-heparin (LMWH) followed by long-term therapy with an oral anticoagulant. Despite the use of standard anticoagulant therapy, there is also a three-fold risk of recurrent venous thromboembolism for cancer patients. In this case report the authors report a case of a 60 year old patient with carcinoma of unknown primary site, who despite standard anticoagulant therapy developed recurrent deep vein thrombosis.Bolesnici s karcinomom imaju četiri puta povećan rizik od razvoja venskog tromboembolizma (VTE); u usporedbi sa zdravom populacijom. Oko 15% bolesnika s karcinomom razvije VTE što predstavlja veliki izazov za profilaksu i liječenje. Standardno liječenje akutnog venskog tromboembolizma počinje sa nisko molekularnim heparinom (LMWH) nakon čega slijedi oralna antikoagulantna terapija. Usprkos terapiji; bolesnici s karcinomom imaju tri puta povećan rizik razvoja recidiva venskog tromboembolizma. U prikazu slučaja prikazan je 60-godišnji bolesnik s karcinomom nepoznatog sijela; koji je usprkos antikoagulantnoj terapiji imao recidiv duboke venske tromboze

Tromboelastografija u dijagnostici hiperkoagulabilnih stanja kod pacijenata s karcinomom-prikaz slučaja

Standard coagulation tests are plasma based and do not give complete information about coagulation in vivo. Thromboelastography is a test which allows coagulation testing in whole blood. It is useful in perioperative management of bleeding patients and results can be helpful in choice of therapy. Aim of our study was to compare thromboelastography results with standard coagulation test results in two patients. Thromboelastography results did not show any abnormalities and results of standard coagulation tests were in concordance with patient’s therapy.Standardne koagulacijske pretrage koje se izvode iz plazme ne daju pravu informaciju o koagulaciji in vivo. Tromboelastografija je pretraga koja omogućava ispitivanje koagulacije u punoj krvi. Korisna je kao pretraga u perioperativnom praćenju bolesnika te može pomoći pri donošenju odluke o primjeni odgovarajuće terapije. Cilj ovog istraživanja bio je usporedtiti rezultate tromboelastografije sa standardni koagulacijskim pretragama kod dva pacijenta. Rezultati tromboelastografije nisu pokazali odstupanja koja bi ukazivala na patološki poremećaj, a rezultati standardnih koagulacijskih pretraga bili su karakteristični za pacijente na terapiji

Recidiv duboke venske tromboze tijekom terapije kumarinima u bolesnika s karcinomom -prikaz slučaja

Cancer patients have a four-fold increased risk of developing venous thromboembolism (VTE), relative to the general population. Affecting about 15 % of patients with cancer, it is presenting a great challenge for prophylaxis and treatment. The standard treatment for acute venous thromboembolism consists of initial therapy with low-molecular-weight-heparin (LMWH) followed by long-term therapy with an oral anticoagulant. Despite the use of standard anticoagulant therapy, there is also a three-fold risk of recurrent venous thromboembolism for cancer patients. In this case report the authors report a case of a 60 year old patient with carcinoma of unknown primary site, who despite standard anticoagulant therapy developed recurrent deep vein thrombosis.Bolesnici s karcinomom imaju četiri puta povećan rizik od razvoja venskog tromboembolizma (VTE); u usporedbi sa zdravom populacijom. Oko 15% bolesnika s karcinomom razvije VTE što predstavlja veliki izazov za profilaksu i liječenje. Standardno liječenje akutnog venskog tromboembolizma počinje sa nisko molekularnim heparinom (LMWH) nakon čega slijedi oralna antikoagulantna terapija. Usprkos terapiji; bolesnici s karcinomom imaju tri puta povećan rizik razvoja recidiva venskog tromboembolizma. U prikazu slučaja prikazan je 60-godišnji bolesnik s karcinomom nepoznatog sijela; koji je usprkos antikoagulantnoj terapiji imao recidiv duboke venske tromboze

Tromboelastografija u dijagnostici hiperkoagulabilnih stanja kod pacijenata s karcinomom-prikaz slučaja

Standard coagulation tests are plasma based and do not give complete information about coagulation in vivo. Thromboelastography is a test which allows coagulation testing in whole blood. It is useful in perioperative management of bleeding patients and results can be helpful in choice of therapy. Aim of our study was to compare thromboelastography results with standard coagulation test results in two patients. Thromboelastography results did not show any abnormalities and results of standard coagulation tests were in concordance with patient’s therapy.Standardne koagulacijske pretrage koje se izvode iz plazme ne daju pravu informaciju o koagulaciji in vivo. Tromboelastografija je pretraga koja omogućava ispitivanje koagulacije u punoj krvi. Korisna je kao pretraga u perioperativnom praćenju bolesnika te može pomoći pri donošenju odluke o primjeni odgovarajuće terapije. Cilj ovog istraživanja bio je usporedtiti rezultate tromboelastografije sa standardni koagulacijskim pretragama kod dva pacijenta. Rezultati tromboelastografije nisu pokazali odstupanja koja bi ukazivala na patološki poremećaj, a rezultati standardnih koagulacijskih pretraga bili su karakteristični za pacijente na terapiji

Koncentracija feritina u serumu kod bolesnika sa solidinim tumorima

Ferritin is a positive acute phase reactant. It is produced and secreted by various cells such as hepatocytes, macrophages and cancer cells. This was a retrospective study which included 46 patients with solid tumors who were tested for ferritin level in plasma. The measured value of the ferritin concentration in plasma of patients was in the range from 5.98 to 850.78 μg/L, and the average measured value was 174.62 μg/L. For the control group, we also included 46 subjects. The measured value of ferritin in the control group was in the range from 5.94 to 351.54 μg/Ll, and the average measured value was 63.17 μg/L. There is a statistically significant difference between the two groups. Our data shows that the highest level of ferritin was measured in patient with breast cancer. By many studies done until now it is shown that iron metabolism is dysregulated in cancer, and that changes occur in both intracellular and extracellular ferritin.Feritin je reaktant akutne faze. Proizvode ga i luče različite stanice, jetrene, makrofagi i neoplastične stanice. U ovoj retrospektivnoj studiji obrađeni su podaci 46 bolesnika sa solidnim tumorima kojima je određena koncentracija feritina u serumu. Koncentracija feritina kod bolesnika kretela se u rasponu od 5,98 do 850,78 g / L, a prosječna izmjerena vrijednost je 174,62 g / L. Kontrolan skupina je 46 zdravih osoba. Izmjerena vrijednost feritina u kontrolnoj skupini kretala se u rasponu 5,94 do 351,54 g / Ll, a prosječna izmjerena vrijednost je 63.17 g / L. Postoji statistički značajna razlika između dvije skupine. Naši podaci pokazuju da je najviša razina feritina izmjerena kod bolesnice s rakom dojke. Mnoge studije učinjene do sada pokazale su da postoji poremećaj metabolizma željeza kod malignih stanja, te da dolazi do promjena i unutarstaničnog i izvanstaničnog feritina

Trombocitna rezistencija na klopidogrelski antiagregacijski učinaku bolesnika sa solidnim tumorima

The anti-aggregating effect of clopidogrel (75 mg/day) on platelet function was monitored in 33 solid tumor patients. Clopidogrel irreversibly blocks the platelet P2Y12 receptor and inhibits platelet aggregation induced by adenosine diphosphate (ADP). Whole blood aggregation was measured using a Siemens PFA-100 aggregometer including the Innovance PFA P2Y cartridge. The mean age of patients was 62 ± 13 years. Among them, there were 19 (58%) males and 14 (42%) females. The values of platelet aggregation >106 seconds and 106 sekunda pokazala je klopidogrelski antiagregacijski učinak u 22 (67%) bolesnika; a vrijednost <106 sekunda uočena je u 11 (33%) bolesnika koji nisu reagirali. Prosječni klopidogrelski antiagregacijski učinak bio je 219 ± 110 sekunda. Agregacijskih razlika između muškaraca i žena nije bilo (p=0;784). Interindividualna agregacijska varijacija bila je 50%. Nije bilo statistički značajne razlike između dvaju mjerenja 7 uzoraka istih osoba u razmaku od mjesec ili više dana; što pokazuje intraindividualnu stabilnost klopidogrelskog djelovanja na trombocitnu agregaciju (p=1;000)