Factor V G1691A has an important role in susceptibility to arterial ischemic stroke, both in the perinatal/neonatal period and in childhood, as well as transient ischemic attacks. A minor impact of human platelet alloantigen polymorphisms suggests that platelet glycoprotein polymorphisms may increase the risk of transient ischemic attacks and migraine, but this should be confirmed in larger studies.
Pra će nje bro ja trom bo ci ta u bo les ni ka s opek li na maPla te let cou nt mo ni to ri ng in bu rn pa tien ts Ma ri na Pavić, La ra Mi le voj Kli ni ka za trau ma to lo gi ju Zag reb, Od jel za la bo ra to rij sku di jag nos ti ku De par tme nt of La bo ra to ry Diag nos ti cs, Uni ver si ty Hos pi tal of Trau ma to lo gy, Zag reb, Croa tia Sa že takUvod: Kod bo les ni ka s opek li na ma do la zi do bit nog na ru ša va nja he mos tatskog i imu no loš kog od go vo ra u ko jem trom bo ci ti ima ju zna čaj nu ulo gu. Cilj is pi ti va nja bio je pra će nje bro ja trom bo ci ta u bo les ni ka s opek li na ma, ovisno o te ži ni opek lin ske oz lje de (pos to tak ope če ne pov r ši ne ti je la bo les ni ka -%TBSA) i is ho du bo les ti (pre živ lje nje/smrt). Ma te ri ja li i me to de: Ukup no smo is pi ta li 68 bo les ni ka: sku pi na A (32 bo lesni ka s lak šim opek li na ma, ≤ 10% TBSA) i sku pi na B (36 bo les ni ka s um je renim/težim opek li na ma, > 10% TBSA). Broj trom bo ci ta od re di li smo na he mato loš kom bro ja ču Sysmex XT-1800i, 1., 4., 7., 14., 21. i 28. da na na kon oz lje de, ovis no o du ži ni bo rav ka bo les ni ka u Kli ni ci. Re zul ta ti: Broj trom bo ci ta 4. i 7. da na u bo les ni ka s ob zi rom na te ži nu ozlje de zna čaj no se raz li ko vao iz me đu sku pi na A i B, a ni ži su bili u skupini B (P < 0, 001; P = 0,045). U ob je ma sku pi na ma 4. u od no su na 1. dan doš lo je do pa da bro ja trom bo ci ta, ali zna ča jan pad bio je pri su tan sa mo u sku pi ni B. Znača jan po ra st bro ja trom bo ci ta u ob je ma sku pi na ma za bi lje žen je 7. u od no su na 4. dan, kao i 14. u od no su na 7. dan. S ob zi rom na is hod bo les ti preživje lo je 56, a um r lo 12 bo les ni ka. U bo les ni ka sa smr tnim is ho dom, u us po red bi s pre živ je li ma ti je kom ci je log pe rio da pra će nja, do bi ve na je zna čaj na raz li ka u bro ju trom bo ci ta (P < 0,05). U um r lih je bo les ni ka bio zna čaj no ni ži broj trombo ci ta svih da na pra će nja, osim pr vo ga da na ka da su bi li zna čaj no vi ši u od nosu na pre živ je le bo les ni ke. Zak lju čak: Do bi ve ne zna čaj ne raz li ke u bro ju trom bo ci ta 4. i 7. da na iz me đu sku pi na pre ma te ži ni opek lin ske oz lje de, kao i zna ča jan pad trom bo ci ta 4. u od no su na 1. dan u sku pi ni um je re nih/težih opek li na, upu ću je na pot re bu uvo đe nja učes ta li jeg pra će nja broja trom bo ci ta u tom pe rio du ra di pra vov reme nog od re đi va nja pada nji ho vog bro ja. U bo les ni ka sa smr tnim is ho dom u od no su na pre živ je le zna čaj no su bi le ni že vri jed nos ti trom bo ci ta ti je kom ci jelog pe rio da pra će nja, osim pr vo ga da na ka da su bi le zna čaj no vi še. Us pr kos prisutnim raz li ka ma pre ma is ho du bo les ti, ali slič noj di na mi ci trom bo ci ta (pora st i pad) u ob je ma sku pi na ma te ma log bro ja um r lih is pi ta ni ka, pot reb na su do dat na is tra ži va nja. Ključ ne ri je či: trom bo ci ti, bo les ni ci s opek li na ma, %TBSA, is hod bo les ti
Risk factors for increased mortality in hip fracture patients include older age, male sex, fracture type, bone mineral density, and pre-existing co-morbidities. The role of biochemical and other anthropometric parameters on hip fracture mortality remains unclear. The aim of this study was to identify the risk factors for one-year mortality in patients with hip fractures. A total of 236 consecutive patients (59 males) with hip fractures were followed over a one-year period. Patient age, gender, type of fracture, type of treatment, time from admission to surgery, type of anesthesia, body mass index, and electrocardiograms were recorded. Complete blood counts, serum electrolytes, urea, creatinine, d-dimers, calcium, phosphate, osteocalcin, and beta-isomerised C-terminal telopeptide of collagen type I (β-CTX) were measured at admission and estimated glomerular filtration rate (eGFR) was calculated. Multivariate Cox regression models were used to analyze the association of these parameters with survival. One-year mortality rate was 28.4%. Age was independently associated with mortality (HR 1.117, 95% CI 1.062-1.174, P < 0.001). In a multivariable model, mortality was increased in patients with higher β-CTX (HR 4.63 95% CI 1.87-11.45, P = 0.001) and lower eGFR (HR 0.972, 95% CI 0.956-0.987, P < 0.001). Patients younger than 84 years, with eGFR < 55.4 ml/min had ten times higher mortality rates (3.2 vs. 24.5%, HR 9.73, 95% CI 2.06-45.93) as well as those with β-CTX > 0.276 g/L (3.5 vs. 25.7%, HR 9.5, 95% CI 2.11-42.76). Advanced age, high β-CTX levels, and impaired renal function are independent risk factors of mortality in patients with hip fractures.
Platelet satellitism (PS) is a rare phenomenon observed in blood smears obtained from blood anticoagulated with EDTA. It is characterised by platelet rosetting around polymorphonuclear neutrophils and in rare cases around other blood cells. PS is a rare cause of pseudothrombocytopenia. References about the phenomenon of PS in medical literature are few. In this report we describe a case of PS fortunately noticed in one trauma patient. Furthermore, we discuss the possible pathophysiological mechanisms of PS proposed in the literature. To our knowledge this is the fi rst case of PS reported in Croatia.
The presence of cold agglutinins (CAs) in samples intended for complete blood count (CBC) using automated haematology analysers might cause serious preanalytical errors. In this report we describe the case of a 90-year old female patient admitted to the Emergency department following trauma injuries. A blood testing on admission revealed surprisingly low red blood cell count (0.99 x 1012/L), low haematocrit (0.102 L/L) which did not correlate with haemoglobin concentration (100 g/L), and high erythrocytes indices (mean corpuscular haemoglobin, 101 pg; mean corpuscular haemoglobin concentration, 980 g/L). In the second sample, after repeated collection, almost equal results were observed. Blood smear examination under the microscope revealed clusters of erythrocytes. Cold agglutinins presence was suspected and, in order to get valid results, sample was warmed to 37 °C. Correction of CBC was observed. Furthermore, we performed some additional analysis to confirm the presence of CAs in this patient. The aim of this report was to present the laboratory findings in a case of CAs and propose a laboratory procedure for whole blood samples with suspected CAs.
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