One-stage surgery is superior to a classic two-stage approach as it decreases the morbidity, hospital stay and costs. MS is an excellent approach, but in some cases, VATS mini-thoracotomies could be indicated.
Background: Atrial fibrillation (AF) is a hypercoagulable state. However, the intimate mechanisms leading to impaired coagulation and the timing of their activation are unclear. The aim of the study was to investigate the factors that initiate the coagulation cascade in the early hours (up to 48 h) of clinical manifestation of paroxysmal atrial fibrillation (PAF).Methods: Tissue factor (TF) level, coagulation activity of factor VII (FVIIa), factor XII (FXIIa) and factor XI (FXIa) were measured in plasma of 51 non-anticoagulated patients (26 men and 25 women, aged 59.84 ± 11.42 years) and 52 controls (26 men and 26 women, aged 59.50 ± 10.53 years) by enzyme-linked immunoassays and kinetic assays.Results: TF was higher in the PAF group (268.63 ± 90.62 pg/mL vs. 170.21 ± 66.19 pg/mL, P < 0.001) as well as FVIIa (170.82±59.39% vs. 95.17±37.90%, P < 0.001), FXIIa (218.31±84.04% vs. 148.41±53.94%, P < 0.001) and FXIa (178.41±55.94% vs. 111.75±37.33%, P < 0.001). Regression analysis showed that in the first 6 h of the disease, increase in time led to increase in FXIIa (r = 0.25, P < 0.05), FXIa (r = 0.75, P < 0.05), TF level (r = 0.25, P < 0.05) and FVIIa (r = 0.25, P < 0.05).
Conclusion:Hemocoagulation changes were observed even < 6 h after the onset of the disease. They suggest that PAF has an early tendency for hypercoagulability, with the involvement of the intrinsic and extrinsic pathways of coagulation.
MX1 (N-[3-(3-(1-piperidinylmethyl)phenoxy)propyl]-hydroxyacetamide+ ++ 2-hydroxypropane-1,2,3-tricarboxylate bismuth (3+) complex) is a novel salt of the active metabolite of H2-antagonist roxatidine with a complex of bismuth with citric acid. In a model of ethanol-induced ulcers in male Wistar rats, both roxatidine and the bismuth salt reduced the number and the total length of lesions. Comparison of roxatidine and MX1 at equimolar doses of 160 mumol kg-1 showed a more potent cytoprotective effect of MX1. The potency of anti-secretory and antiacidic effects of MX1 was more than twice that of roxatidine on histamine-stimulated secretion in female Wistar pylorus-ligated rats. Microbiological tests with the reference bismuth preparation De-Nol showed prominent anti-Helicobacter properties of MX1 in-vitro. Both test compounds had similar range of MICs to Helicobacter pylori, from 4 to 64 microgram bismuth mL-1. The cytoprotective, antisecretory, anti-acidic and anti-Helicobacter properties of the new agent MX1 warrant further more extensive pharmacological and clinical trials.
Хроничното бъбречно заболяване (ХБЗ) е прогресивно болестно състояние, което може да достигне до терминален стадий на хронична бъбречна недостатъчност (ESRD). От съществено значение е да можем да идентифицираме хората с висок риск за прогресия на ХБЗ и свързаните с него сърдечно-съдови заболявания (ССЗ). Протеинурията е най-чувствителният маркер за прогресия на ХБЗ в клиничната практика, особено когато се комбинира с eGFR, но те имат известни ограничения. Идентифицирани са обещаващи специфични и високоселективни биомаркери, свързани с ранното установяване и превенция на ХБЗ. Качеството на живот (QOL) при тези пациенти е изключително важно и е свързано с тяхната функционална активност, благополучие, общо възприемане на здравето във физически, психологически и социални аспекти. Наблюдаваната при пациенти с ХБЗ малнутриция, промяна в ритъма на ежедневието, също допринася съществено за влошеното им качество на живот.
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