The Role Of Idiopathic Trombocytopenic Pumpune Responses

The Role Of Idiopathic Trombocytopenic Pumpune Responses
There is a rising acknowledgement of the dire role platelets play in the inflammation and immune responses. Platelets release copious inflammatory
mediators that have no known role in hemostasis. Several of these mediators modify leukocyte and endothelial responses to a variety of diverse
inflammatory stimuli. Additionally, platelets form a bond with leukocytes and form conduits between leukocytes and endothelium, largely mediated by
platelet P–selectin. Through their collaboration with monocytes, neutrophils, lymphocytes and the endothelium, platelets are therefore essential
controllers of inflammation and both innate and adaptive immune responses. Occasionally, the body's immune system mistakenly attacks and destroys
platelets ... Show more content on Helpwriting.net ...
It is extremely important to notify health care providers if any of the following signs and symptoms of bleeding occur: easy bruising of the skin,
petechiae, blood in urine, black tarry stools, nosebleeds, bleeding from the gums, increase in vaginal bleeding, and new onset of painful joints.
(Williams, L. S., & Hopper, P. D. (2015, p. 573–574).
Idiopathic thrombocytopenia purpura (ITP) is clinically diagnosed through a thorough medical history including a physical examination, complete
blood count (CBC), and peripheral blood smear examination. (Blackwell, J., & Goolsby, M. J. (2003)). Upon examination of laboratory results,
prolonged bleeding time and a platelet count of less than 20,000/mm3 may suggest that one has ITP. Furthermore examination of platelets under a
microscope show cells to be small and immature in appearance. Typically platelets have a lifespan of seven to ten days, but the immature platelets
cells seen under the microscope may only survive for a few hours. Anemia is another complication that can result from the loss of blood, given that
the person has a bleeding episode. (Williams, L. S., & Hopper, P. D. (2015, p. 573–574). Pregnancy can furthermore make a diagnosis of ITP more
complex.
The number one goal of treatment for idiopathic thrombocytopenic purpura (ITP) is to have no bleeding and a normal platelet count. The majority of
acute ITP cases resolve themselves
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Lumbar Spinal Anesthesia Essay
Group A: Twenty patients who receive lumbar spinal anesthesia with dose of 0.04mg/cm height. Group B: Twenty patients who receive lumbar spinal
anesthesia with dose of 0.05mg/cm height. Group C : Twenty patients who receive lumbar spinal anesthesia with dose of 0.06mg/cm height.
Exclusion criteria for the study included: Patient refusal to consent (absolute), infection in the patients back near the proposed site of the injection,
coagulation disorder :–( defined as PT: > 18 sec, PTT: >40 sec, I.N.R: > 1.5, clotting time: >8 min, platelet disorder: platelet count: < 100.000, bleeding
time: >4 min, HELLP Syndrome: – (defined as Hemolysis, Elevated Liver enzymes, Low Platelet count), receiving any anticoagulant drugs, preexisting
neurological disease or psychic patients, history of cardiac and respiratory system failure, known allergy to local anesthetics drugs, coexisting renal
disease and eclamptic patients.
Methodology
On arrival to the operating room, all patients were continuously monitored with electrocardiography, non invasive blood pressure and pulse ... Show
more content on Helpwriting.net ...
If inadequate spinal anesthesia occurs general anesthesia is used for patients and they will exit from the

Research Study on the Interaction Among Platelets and...
Subjects
The study subject was divided into 4 groups. Group I: 21 patients with hepatic schistosomiasis (12 male and 9 females). Group II: 18 patients with
HCV infection (10 male and 8 females). Group III: 23 patients with concomitant hepatic schistosomiasis and HCV infections (13 male and 10 females).
Group IV: 20 healthy individuals as controls (12 male and 8 females). Full history taking including contact with water canal water were collected from
the study subject
Abdominal ultrasound
Ultrasonography was conducted to all study subject to assess the hepatic physical condition including the grading of portal tract thickening in S.
mansoni positive patients and the extent of liver cirrhosis.
Liver function tests
Serum levels of AST,... Show more content on Helpwriting.net ...
HCV–RNA levels were analyzed by real time polymerase chain reaction using a commercial kit (Bioer, Technology Co., Ltd) according to the
manufacturer's instructions.
Flow–cytometeric analysis
Platelets rich plasma (PRP) were separated and freshly tested for CD41, CD42, CD62P and CD63 expression using fluorescein isothiocyanate (FITC)
and phycoerythrin (PE) conjugated monoclonal antibodies (mAbs) (BD Biosciences. Com, Pharmingen TM). The flow cytometry for the immune
cells, EDTA treated blood was labeled with 10 Вµl monoclonal antibodies (mAbs) in 3 tubes. Tube 1 forT cell contained CD3–peridin chlorophyll
protein (PerCP), CD4–fluorescein isothiocyanate (FITC) and CD8–phycoerythrin (PE). Tube 2 for NK cells contained CD16/CD56 PE and CD 3
FITC. Tube 3 for B cells contained CD19 FITC and CD22 PE (all Becton Dickson, San Jose, Calif). A non specific Isotype Control was used in each
sample. All antibodies were of IgG1k Isotype Flowcytometer Epics В® Elite К»К»CoulterКјКј system was used for analysis. Results were expressed
as a specific percentage of positive markers, calculated by subtracting the non specific fluorescence of the Isotype control form the specific fluorescence
of the mAbs. For subtraction, the manufacturer's software was used [15].
Statistical analysis
Statistical analysis was performed using Instat software. ANOVA test was

The Effects Of Wound Healing On Diabetic Patients
eous wound healing and why some processes may be altered in diabetic patients
"The process by which tissue repair takes place is termed wound healing and is comprised of a continuous sequence of inflammation and repair, in
which epithelial, endothelial, inflammatory cells, platelets and fibroblasts briefly come together outside their normal domains, interact to restore a
semblance of their usual discipline and having done so resume their normal function". ("The Cellular Biology of Wound Healing" 2016)
Wound healing has 3 distinct stages, an inflammatory response, a proliferation phase and a maturation phase, however wound healing is not a linear
process and a patient can move back and forth throughout the stages.
After the occurrence of a wound the inflammatory process immediately begins and can last up to 3 days ("Wound Healing" 2016), the initial injury
causes the small vessels around the wound site to be disturbed resulting in bleeding, the body's first response is a haemodynamic one in that it restricts
these vessels in order to prevent blood loss. There then comes a rapid release of preformed inflammatory mediators from the cells surrounding the injury,
the first thing this causes is the aggregation of platelets, these platelets adhere to extracellular surface structures which are exposed, such as collagen
and basement membranes, this in turn causes serotonin from platelet stores to be stimulated. (Kirk, Phillips and Murray 2001)
As well as attracting further

Hemostasis Research Paper
Hemostasis is the process that causes bleeding to stop. It also changes blood from a liquid to a gel. It consists of three processes, vascular spasm,
platelet plug formation and blood coagulation. Vascular spasm is the first step in heeling in the wound. Vascular spasm is when the damaged blood
vessels constrict due to tightening of muscle cells on the inside wall. This helps decrease blood flow, thus minimizing blood loss. Then platelet plug
formation occurs. This is when platelets adhere to the damaged endothelium and form a plug. Normally platelets do not stick to the endothelial lining
but during an injury collagen is exposed. The exposed collagen activates the platelets to stick together and form a plug. Once the platelets are stuck
together

The Danger of Deep Vein Thrombosis
Deep vein thrombosis (DVT) is a type of cardiovascular disease. DVT is a blood clot that forms in the large deep veins in the leg or pelvis area
and grows toward the heart. Including the veins in the calf and thighs, the femoral, popliteal, and iliofemoral vein are also the sites of DVT
development. It is a mainly common and dangerous condition (Kesieme et al., 2011). Some DVTs may cause no pain or swelling, whereas others
might be quite painful and result in a lot of swelling. Mortality is not high with prompt diagnoses and treatment for most DVTs. However some
can be a threat to your life, especially the ones that develop in the deep veins as compared to the clots that develop in the visible superficial veins.
Clot which forms in the deep veins is more likely to break free and travel through the veins, which is then called an embolus. When an embolus
travels from the legs or pelvis area and lodges into the lung artery, the condition is known as a pulmonary embolism or PE. This is a potentially
fatal condition if it is not treated immediately and can lead to death. As high as 50% of the time a DVT can progress to pulmonary embolism.
Collectively, DVT and PE are known as venous thromboembolism (VTE). DVT and PE are highly preventable (Kesieme et al., 2011). Both DVT and
PE are a major public health problem worldwide. DVT affects approximately 0.1% of persons per year. The overall average age and sex adjusted
annual incidence of VTE is 117 per 100,000, with higher rates among

Thrombosis Lab Report
Introduction
Erythrocytes (red blood cells – RBCs), leukocytes (white blood cells – WBCs), and thrombocytes (platelets) are there primary components of blood.
All are produced and developed in the bone marrow with the participation of other organs and systems such as lymph nodes, spleen, and liver. This
process is called hematopiesis.
Most hematologic diseases and surgery complications related to blood can be detected through the complete blood count (CBC). WBC with or without
differentials, RBC, Hct, Hgb, and platelet counts are usually included in the CBC. It is critical for a nurse to know how to interpret the lab values to
indicate complications but still prevent overreaction to mild abnormalities toward each patient without clinical correlates. The "normal" values related to
... Show more content on Helpwriting.net ...
Nursing process for some "abnormal" results
The increase in RBC count is called polycythemia. Patient will have increased risk of venous thrombosis as the blood is more viscous. Nurse
implementation would be monitor and maintain adequate hydration status especially for patient being NPO during an extended time causing
dehydration. Specific order will be needed for patients with chronic lung diseases or children with congenital heart defects, as there are risks as if the
patients is dehydrated or overhydrated.
On the other hand, a decrease number of hemoglobin is known as anemia affected the blood's ability to carry oxygen to body tissues. It can be
classified by cellular morphology including cell size, color and shape, or by physiologic process such as

Medical Report: Case Study Questions Essay
Case Story, Question 1
How would Ed's blood help protect him from a foreign invader such as the one now in his system?
Ed's blood contains white blood cells, which combat infection and inflammation. Foreign invaders attract phagocytic neutrophils and macrophages by
means of chemotaxis. These particular cells eat and dispose of pathogens in a process called phagocytosis. These cells ingest and dispose of pathogens
and dead matter during phagocytosis.
The sporozites have traveled ot Ed's liver; how is the function of hepatocytes related to blood?
Hepatocytes are involved in synthesizing proteins, cholesterol, bile salts, fibrinogen, phospholipids and glycoproteins. Additionally, hepatocytes ensure
that our ... Show more content on Helpwriting.net ...
Generally, bilirubin enters the liver and is transported to the liver where it is then secreted by liver cells into bile.
Why would Ed potentially need a transfusion of blood?
Ed's blood count is low due to the increased destruction of RBC's. Erythropoesis cannot keep up with the destruction of RBCs, thus a blood transfusion
is probably needed. This is done to allevia anemia, increase blood volume and to improve immunity against the parasites that have infected Ed's body.
Destruction of Ed's red blood cells has caused damage to his kidneys. How is the kidney involved in blood cell production?
Hypoxia stimulates the kidneys to increase the release of the hormone erythropoietin. Erythropoietin is produced by the kidneys to increase the number
of RBC precursors. Erythropoiesis is the process of red blood cell formation.
Which type of WBCs phagocytizes damaged tissues and pathogens and may have been active early in Ed's infection (at the site of the bite where
inflammation was occurring)?
Neutrophils and wandering macrophages (originating form monocytes) were most likely the WBCs that phagocytized the tissues and pathogens early

in Ed's infection. They gather at sites of infection or inflammation by means of emigration. They are

Blood Disorders
Blood Disorders
Amanda Swindell
HCA/240
August 9, 2015
Dr. Monica Chase
Blood Disorders
Blood is one of the most essential elements within the body. Blood is made up of plasma, red blood cells, and platelets. Blood is vital to the body
functioning correctly, and it is important to understand that there are many types of blood disorders that can cause people to get sick. While there are
many different types of blood disorders out there, this paper is going to cover three which are, anemia, sickle cell, and thrombocytopenia. Also, a
review of plasma, red blood cells, and platelets to give a better understand of blood disorders.
Plasma is the liquid portion of blood. Plasma is made up mostly of water and contains dissolved proteins, carbon ... Show more content on
Helpwriting.net ...
He may have the sickle cell trait.
Sickle cell anemia is a genetically transmitted disorder marked by episodes of painful crisis, severe hemolytic anemia, and increased susceptibility to
infections. This disorder usually affects African American (Zelman, Tompary, Raymond, Holdaway, & Mulvihill, 2010) Since this disorder is
inherited and affects African–American this puts Davon at a higher risk. Sickle cell anemia can be diagnosed by having a genetic testing and blood
test. Some symptoms of this disorder are pain crisis, fatigue, splenic sequestration, bacterial infections, shortness of breath, and eye damages. Some
treatments for sickle cell anemia are supportive therapy during the crisis, blood transfusions, and prevention of sickle cell crisis. Since this is an
inherited disorder, there is no prevention. This blood disorder is usually diagnosed in childhood and persists throughout a person's life ("Mayo Clinic",
2015).
The last scenario and blood disorder is Spencer, who over the past several weeks is having more bruises, or ecchymosis, all over his body. After
coughing this morning, Spencer noticed tiny red marks all around his eyes. Spencer is showing signs of thrombocytopenia. Thrombocytopenia is a
condition of the blood in which the blood doesn't clot properly because there are not enough platelets. This condition can be caused by many different
things such as decreased platelet production, increased platelet

Von Willebrand Disease Research Paper
Von Willebrand disease is a condition that can cause extended or excessive bleeding. This condition is the most common inherited coagulation disease
in domestic animals but in rare cases may develop later in life. Von Willebrand factor is a large glycoprotein that circulates with factor VIII and is
responsible for the combination of platelets at the beginning of the coagulation cascade. The cause of von Willebrand disease is a deficiency in or
impairment of a protein called von Willebrand factor, an important component in your blood clotting process.
Etiology: von Willebrand disease is an inherited defect in the gene that controls von Willebrand factor which is a protein that plays a key role in your
blood–clotting process. When von Willebrand factor is scarce or not functioning properly because of structural abnormalities, thrombocytes(platelets)
cannot stick together properly, nor can they attach themselves normally to the blood vessel walls when an injury has occurred. The result is
interference with the blood clotting process and ... Show more content on Helpwriting.net ...
There are different classifications of von Willebrand disease. Type 1 von Willebrand cubes mild to moderate symptoms and the most common form.
The more severe ones are Type 2 and 3 which are less common. Von Willebrand disease only affects clotting (hemostasis) and causes no other disease
effects. The genetics of this disease has been investigated and they found that a single gene, autosomal recessive, condition in which the normal gene is
affected by a splice site mutation. The result of this is the reduced rate of von Willebrand factor(vWF) production. Some of the breeds that are at risk
are Doberman Pinschers, German Shepherds, Golden Retrievers, Miniature Schnauzers, Pembroke Welsh Corgis, Shetland Sheepdogs, Basset Hounds,
Scottish Terriers, Standard Poodles, and Manchester

Glanzmanns Disease
Intro/History Glanzmanns disease also known as, Thombasthenia–Glanzmann is a rare disorder of blood platelets, which result in easy bruising and
nosebleeds, and was first described in 1918. Glanzmanns disease is a congenital hemorrhagic disorder, meaning it's a bleeding disorder present at birth.
Glanzmanns disease results from not having enough glycoprotein, a protein usually found on the surface of blood platelets. Platelets are small blood
cells that are the first responders in the case of a cut or injury, they normally clump together to form a plug in the wound and stopped bleeding.
Glanzmanns Disease
Glanzmanns disease is a hereditary disease. Glanzmanns disease has differing severity. In type I there is a severe less than 5% deficiency ... Show more
content on Helpwriting.net ...
The defects seen in Glanzmann disease are split equally between glycoprotein IIb and glycoprotein IIIa.
References
McCartney CA, Paredes N, Chan AKC. Disorders of coagulation in the neonate. In: Hoffman R, Benz EJ Jr, Silberstein LE, Heslop HE, Weitz JI,
Anastasi JI, eds. , Hematology; basic principles and practice 6th ed. Philadelphia, PA: Elsevier Saunders, 2012 chap. 152 www.nlm.nih.gov/medlineplus
/ency/article www.nlm.nih.gov/medlineplus/encylopedia.html
Nurden AT, Pillois X, Wilcox, DA. Glanzmanns thrombasthenia: state of the art, and future directions. Semin Thromb Hemost. 2013; 39: 642
–55
www.nci.nlm.nih.gov/pubmed 3/1/16 12:43pm
Updated January 27, 2015
Updated by: Yi–Bin Chen, MD
Leukemia/ bone marrow Transplant program, Massachusetts General Hospital, Boston, MA.
Reviewed by David Zieve, MD MHA, ISIA Ogilvie, PhD and the A.D.A.M editorial team.
Glanzmanns thrombasthenia. (2016, Jan. 18). Retrieved from www.ghr.nlm.nih.gov/condition/glanzmann–thrombasthenia.
Nurden, AT (2006). Glanzmanns thrombasthenia. Orphanet journal of rare diseases, 1 (10). Retrieved from

Sickled Red Blood Cell Disease: A Case Study
Plasma would carry white blood cells, red blood cells, and platelets to the injury site, which is the scrape on the hand. Platelets would attach with each
other, building a blockade to stop blood flow at the injury site. White blood cells would attack and kill foreign substances that enter through the injury
site and try to hurt the body. Red blood cells would provide oxygen at the injury site to help heal the injury, having that platelets have created a
blockade.
A defining feature found in sickle cell disease is how red blood cells are organized. In sickle cell disease, red blood cells attach to each other and create
a compact organization. However, normal red blood cells stay apart from each other that the individual shape of each red blood cell can be seen. The
organization of red blood cells is distinct in sickle cell disease, and therefore a ... Show more content on Helpwriting.net ...
The abnormal shape of a sickled red blood cell is a crescent shape and the shape causes the sickled red blood cell to become sticky and attach to other
sickled red blood cells as well as blood vessels. Since a sickled red blood cell can attach to other sickled red blood cells and blood vessels, clotting in
blood vessels can occur, and the movement of sickled red blood cells are affected.
I think the abnormal shape of sickled red blood cells causes episodes of severe pain in the joints, chest, and abdomen and swelling in the hands and feet
because the abnormal shape of the sickled red blood cells attach and clog blood vessels. The clogging of blood vessels can cause pain within the body
and swelling as a result of the many sickled red blood cells attached together at one area of a blood vessel. Therefore, the abnormal shape of sickled red
blood cells cause pain and swelling symptoms because sickled red blood cells attach to each other and to blood

Reflection Paper In Nursing
The first patient for the day walked in at 0830. Lynn, RN went to greet M. S. and she invited me over to take her vital signs. Lynn verbalized her
focused assessment of the outpatient for me. The patient denied any problems. Ensuring the patient's privacy and offering to apply ethyl chloride as a
topical anesthesia for the patient's comfort, Lynn then accessed the patient's port. She first drew a syringe of blood to waste. Lynn then quickly placed
the pre–labeled sample tubes as they filled with blood into a bio–hazard bag and personally delivered the samples to the lab for priority processing. She
stated that all laboratory studies for the onocology department take highest priority by the lab. Lynn discussed the lab results with the patient. She
explained that the patient is in the Nadir of her treatment and that is why the physician is holding her treatment. Her platelets were at 18 and she will
be receiving platelets Tuesday. Lynn, explained that it is the facility's protocol to give platelets when the patient is at or below 20.
The morning went on in similar fashion the nurses greeting, assessing, and accessing ports for lab samples, while I took their vitals. Then at 0930, I
focused on S. G. a 64 male diagnosed by computed tomography last September with Rectal adenocarcinoma at stage IV that had metastasized to his
liver. His vital signs were stable. Patient has no known allergies. His height 175.3 cm, his weight 75.8 kg, and his BSA at 1.92 m2 were

How Blood And The Body Is Made Up Of Many Different...
Blood Disorders
Natasha Hurndon
HCA/240
Janet Jowitt
October 13, 2014
The blood in the body is made up of many different components. The components of the blood include red blood cells, plasma, and platelets, each
having a specific function. In this paper I will explain the difference between the three and the specific function they carry out within the human body,
as well as how the relate to the scenarios in this week's assignment. Red blood cells are the most needed of the three components. Basically, the main
purpose of red blood cells is to transport oxygen throughout the body (BloodSource, 2014). A person who is experiencing extreme blood loss would
definitely need red blood cells in order to survive. The liquid part ... Show more content on Helpwriting.net ...
"Iron deficiency anemia is due to an insufficient amount of iron (Mayo Clinic, 2014)." If there is a lack of iron the body cannot produce enough
substance in red blood cells in order to transport oxygen (Mayo Clinic, 2014). As with any condition there are always symptoms. The symptoms
for iron deficiency anemia includes extreme fatigue, pale skin, weakness, shortness of breath, chest pains, frequent infections, headaches,
dizziness, cold and feet, poor appetite and the list goes on (Mayo Clinic, 2014). All of Lily's symptoms can be compared with the ones that I just
mentioned. Despite the symptoms iron deficiency anemia can usually be corrected with iron supplements. However, it is important that Lily's
mother takes her to see a doctor so that she can be properly diagnosed before giving her any types of supplements. There maybe be other test or
treatments that the doctor may want to perform. Next there is Davon, a 5 year old African American male who carries the sickle cell trait. There are
many individuals with the sickle disease. However, those of African descent such as Davon are affected more and are at greater risk for having this
trait. People who have the sickle cell trait inherit the gene from one or both of their parents (CDC, 2013). People with the sickle trait have one sickle
cell gene and one normal

Panax Notoginseng Research Papers
Growing up as an Asian American, height has been a topic that arose amongst the conversations. In Chinese culture, parents often like to showcase
their kids and like to brag about their accomplishments, their goals and their physical appearance. With that in mind, families including mine took
height as an obstacle that would make my family proud. Puberty affected my body around the end of my elementary school. I specially remember
when I was in Taiwan and was on my way to my friend's house, when my mom gave me a dark, oily brown colored soup put in a water bottle. My
mom told me to drink it on the way to his house and the taste was so bad that I almost fainted that night. The soup was composed of a Chinese herb
prescribed for growth enhancement. This Chinese herb that was prescribed was known as Panax Notoginseng, also known as Tienchi Ginseng and my
mom believed that this soup increased height. Eventually I started to believe that plants had the ability to increase body growth such as my height.
However, after looking up many resources, I found that Panax Notoginseng had many different effects that promoted health but didn't necessarily
increase height.
After several hours of research, many of those hours, including frustration at the failure to a ... Show more content on Helpwriting.net ...
In February 2016, the Neural Regeneration Research administered Xuesaitong capsules, whose main ingredient is Panax notoginseng saponins into rat
models for 28 successive days and monitored them through a biomedical technique that detects antigens and antibodies in a sample. The experiment
showed that high doses of Xuesaitong significantly increased the level of stem cells, which would promote the increase of the mobilization of bone
marrow stem cells and peripheral blood. (Zhang et al,

Haemostasis Essay
Haemostasis is a normal physiological process to stops bleeding and maintains blood in the fluid state.
The major role of Haemostasis is make balance between pro–thrombotic and anti–thrombotic.
Components of Haemostasis:
1. Blood vessels
2. Platelets
3. Coagulation proteins . 4. Fibrinolysis.
Haemostasis divided into two part based on components and plug formation:
1.Primary Haemostasis:(Blood vessels, Platelets)make unstable platelet plug formation as end point .
2.Secondary Haemostasis: (Coagulation proteins) make stable clot formation as end point.
Primary Haemostasis + Secondary Haemostasis = stable fibrin–platelet plug.
Haemostasis divided into two part based on function:
–Blood vessels , Platelets and Coagulation factor : the function of this three components is make thrombus formation.
– Coagulation inhibitors and Fibrinolysis : to Localize thrombus on injury and Prevent new thrombus formation.
How this process is done? ( Through the following explanation we will understand the function of each component of Haemostasis)
п‚§In Primary Haemostasis:( Adhesion,degranulation and aggregation)
–After injury the endothelium of blood vessel ... Show more content on Helpwriting.net ...
–Negatively charged phospholipid membrane .
–May carry tissue factor.
This causes activation of Secondary Haemostasis.
п‚§In Secondary Haemostasis:( Coagulation Factors)
Coagulation factors circulate in the plasma as Zymogen (inactive form).
Blood coagulation involves a biological amplification system. There are two Model of Coagulation "Cascade" and Cell–based .

–The Classical "Cascade" Model of Coagulation:
It is help us to understanding of how coagulation process occurs in vitro and interpretations of laboratory tests for coagulation system
abnormalities(This is the reason they are used so far). But there are Disadvantages in thes model.
For extrinsic pathway use PT test ,for intrinsic pathway usePTT and for common pathway use TT test.
–The Cell–based model

Platelets
Platelets, along with red cells and plasma, form a major proportion of both human blood.
Platelets are fragments of the cells in bone marrow, called megakaryocytes. Stimulated by the hormone thrombopoietin, platelets break off the
megakaryocytes and enter the blood stream, where they circulate for about 10 days before ending their cycle in the spleen. In the healthy body,
thrombopoietin will help to maintain the count of platelets at a normal level. Platelets provide the necessary hormones and proteins for coagulation.
Collagen is released when the lining of a blood vessel is damaged. The platelet recognizes collagen and begins to work on coagulating the blood by
forming a stopper, so further damage to the blood vessel is prevented. A higher than normal count of platelets, known as thrombocytosis, can cause
serious health risks. Too much clotting of ... Show more content on Helpwriting.net ...
Conversely, lower than normal counts can lead to extensive bleeding. The body has several defences against pathogens so we do not fall ill with
the diseases they cause. In addition to being the smallest blood cell, platelets are also the lightest. Therefore they are pushed out from the centre of
flowing blood to the wall of the blood vessel. There they roll along the surface of the vessel wall, which is lined by cells called endothelium. The
endothelium surface prevents anything from sticking to it. However when there is an injury or cut, and the endothelial layer is broken, the tough
fibers that surround a blood vessel are exposed to the liquid flowing blood. It is the platelets that react first to injury. The tough fibers surrounding the
vessel wall, attract platelets and platelets then clump onto these fibers, providing the initial seal to prevent bleeding, the leak of red blood cells and
plasma through the vessel

Hemostasis Research Paper
Hemostasis is a physiological body response to the event of a vascular injury or a damaged vessel. On the other hand, thrombosis is a pathological
response when the hemostatic mechanisms are incorrectly activated leading to blood clots formation 1.
The main blood component engaged in hemostasis, and subsequently in thrombosis too, are the platelets. Platelets during hemostasis adhere to the
injured vessel wall creating a barrier that blocks the blood loss. The initial platelet adhesion is followed by platelet aggregation and platelet–platelet
adhesion which are induced by cytokines released by the activated platelets. As a final step in hemostasis, the coagulation cascade is stimulated with
final result thrombin and fibrin formation at the site of damage. 1,2 ... Show more content on Helpwriting.net ...
Thrombus formation is generated by vessel damage and the subsequent thrombogenic stimuli exposure and consists of activated platelets and fibrin
protein. 3 This barrier that is created limits the blood flow through coronary vessels causing myocardial ischemia. Thus coronary blood vessel
thrombosis is related to pathologic events of acute coronary syndromes which include unstable angina, myocardial infarction, and sudden ischemic
death. 3,4
Uncontrolled platelet aggregation has been associated with thrombosis and subsequently with acute coronary syndromes; therefore the development of
therapeutic interventions has been focused on interrupting one or several stages in hemostasis, platelet aggregation and/or coagulation. 3
Eptifibatide is a cyclic heptapeptide which originated from a protein found in the venom of the southeastern pygmy rattlesnake (Sistrurus miliarus
barbouri) and selectively blocks the platelet glycoprotein IIb/IIIa receptor. It belongs to the class of the so called arginin–glycin–aspartat–mimetics and
reversibly binds to

Cardiovascular Events And Progression Of Ischemia And...
In 2014, myocardial infarctions were the second lead cause of death in Northern Ireland, proceeded only by malignant neoplasms. (Department of
Finance and Personnel. (2015)
They occur as a result of an imbalance between the demand for oxygen and its supply by the coronary arteries. Indeed, MI's can occur as a result of
complications with anemia and heart spasms. However, the main cause of the condition is produced as a result of atheroma.
Under normal physiological conditions platelets mediate the coagulation of blood and have an important role within the process of haemostasis. It is
only when pathological processes arise that inappropriate and threatening activation of platelets becomes apparent. Indeed, it is a well known
phenomenon that platelets are involved in the pathogenesis and progression of ischemia and myocardial infarctions and it is therefore this aim of this
review to summarize the inappropriate activation within the cardiovascular events and how this is related to presentation of a myocardial infarction.
Introduction
"Platelets represent an important linkage between inflammation, thrombosis, and atherogenesis," and have a critical role within the circulatory system
in the maintenance of normal haemostasis. (Gawaz, A., et al. (2005) Platelets primary role and function are in the protection against unwanted blood
loss via thrombus formation, in which, platelets along with red blood cells and the insoluble protein fibrin, form a platelet plug. Indeed,

The highest mortality rate in trauma patients with massive...
The highest mortality rate in trauma patients with massive haemorrhage initially develops with hypothermia, coagulopathy and acidosis. Coagulopathy,
which can be defined as the disorder whereby the body experiences the inability of the blood to coagulate, together with hypothermia and acidosis, form
the three main components of "the trauma triad of death"(Anthony et al, 2005) and in lieu of this fact, it is important to ascertain the role of
temperature on maintaining homeostasis. With this in mind, an experiment to investigate how the temperature of clotting chemicals affect blood
coagulation in the circulatory system, specifically in the cases of hyperthermia and hypothermia, and the effects on homeostasis within the body, will be
This organ system has a number of functions namely, to keep a constant body temperature as well as to ensure coagulation occurs specifically at the
site of injury, as well as to ensure no added blood loss occurs to cause life–threatening effects. This process of blood coagulation is explained in three
interconnected phases. In the first phase, the enzyme thrombokinase is activated due to the damage of tissue and the breaking down of platelets.
Prothrombin is converted into thrombin by the disintegration of the thrombocytes, electrically charged calcium ions and other coagulation factors, as
well as the blood activator and tissue activator which become involved in the coagulation process. The second phase includes production of the
thrombin that transforms fibrinogen in the blood plasma into fibrin. The thrombus (or blood clotting) is formed by a fibrilliform mesh that encloses
the blood cells. Lastly, the third phase, which takes place as retraction occurs of the fibres of the fibrin mesh. Solidification of the fibrous mesh takes
place which closes the defect in the vascular wall. Coagulation is then followed by fibrinolysis (re–dissolution of the clot).
Hypothermia, an important factor of coagulation as mentioned earlier, is described by Danzl et al (2009) as "a potentially fatal condition when the
body loses more heat than it can regenerate." The core temperature being below 35МЉ C. According to Anthony et al

Bleeding In Red Blood Cells And Platelets
The second portion of blood is made from solid components, both formed and fragmented cells. When bleeding occurs somewhere in the body, the
solid components of the blood each have their own unique responses as well. These components are Red Blood Cells (RBCs), White Blood Cells
(WBCs), and Platelets. RBCs are formed cells that hold the oxygen within the blood. These cells are made of a hollow membrane that can hold oxygen
and is flexible enough to squeeze through small vessels like the capillaries. (Tortura 696). When blood loss is significant enough to disturb oxygen
transfer to cells, the body attempts to compensate by mass producing in the skeletal tissue (Red Cross 159). Another formed cell is the WBCs or
leukocytes that hold the primary function of preventing infection in the blood stream. ... Show more content on Helpwriting.net ...
with wounds that have broken through the skin, WBCs will gather around the point of entry to fight infection and prevent any further damage to
systems (Tortura 699). However, in the case ofhemostasis, the most important contributors are the Platelets, cell fragments that are held together with a
membrane (702). As bleeding occurs, various chemicals and enzymes that are contained within platelets activate, causing the cells to become sticky and
encourage accumulation to one another. This coagulation of platelets at the broken vessel's entry site will eventually form a solid plug, resulting in
effective clotting. . Clotting is essential to stop major bleeding of vessels throughout the body, especially in the case of hemorrhagic or hypovolemic
shock

Neurological Paper
Neurological Changes in a Patient with Several Brain Masses During clinical this week, I took care of an 81 year old man who was admitted for having
an altered mental status and brain masses. The family was at the hospital and had to quickly make the decision on whether they wanted to go through
with a craniotomy and have the masses biopsied to further go through with treatment, or to choose the comfort measures option. Throughout my time at
clinical this week, I was able to recognize a neurological decline in this patient's condition. Throughout this paper, the change in this patient's condition,
my actions, the collaboration with team members, interventions, follow–up care, and the rationale will all be furthered explored.
Observing a ... Show more content on Helpwriting.net ...
These platelets did not get done in time, therefore we once again had to collaborate with the surgical team and let them know that he still needed to get
one more unit of platelets. According to Cooper et al., a quasi–experimental design was done to assess the nurse teams' abilities to manage deteriorating
patients. Both skill performance and situation awareness were analyzed. Results showed that only 64% of nurses knew that their patient's condition
was deteriorating. A 57% rating was given for teamwork. Overall, this study showed that there was a low application of knowledge shown by the
nurses. It is suggested that nurses be taught how to identify when a patient's condition is deteriorating (Cooper et al., 2012). According to Chan, Zhou,
& Liaw (2013), ineffective nurse–physician collaboration leads to work dissatisfaction and compromised quality patient care. A literature search was
done to explore the attitudes of physicians and nurses towards their collaboration, the factors that affect physician–nurse collaboration, and also
strategies to improve this. Results showed that physicians viewed the physician–nurse collaboration as less important, although they rated the quality
of the collaboration higher than the nurses did. Factors that affected the collaboration included respect, trust, unequal power, understanding their roles,
and also task prioritizing. Two ways to improve the

The Bone Marrow
The bone marrow is layers of tissue found inside bones, made up of specialised cells called megakaryocytes which have the responsibility of
producing thrombocytes(platelet) (6). The main role of platelets is the formation of blood clots to prevent excessive bleeding which can have
dangerous complexities on health. Thrombocytes work on a specific layer called the endothelium made up of simple, squamas cells called endothelial
cells. The function of the endothelium is to act as a semi–permeable barrier, assist in vasoconstriction/dilation and help in thrombosis. When this layer
is damaged, blood can rapidly escape, in that case platelets form bonds with protein fibres. By binding together, it blocks the space for blood to escape
out of the blood ... Show more content on Helpwriting.net ...
Enteric coating is made up of many tightly bound cellulose fibres. This coating is designed to be pH dependant and prevents dissolution or release of
the drug. This is to prevent it interacting with the body at those regions especially the stomach. Aspirin is particularly harmful to the stomach because
of the impact it has on prostaglandin production. Prostaglandins have numerous functions one of which is a process called cytoprotection. (10)
Cytoprotection reduces HCL production from the parietal cells and stimulate alkaline mucus production needed for neutralisation, which are necessary
to protect the mucosa from damage caused by gastric juices and acids. Furthermore, prostaglandin help dilates vessels to increase the volume of blood
flow to the stomach, in turn increasing rate of repair and renewal of cells and as importantly carrying away acids from the stomach which can damage
the mucosa lining (11). Therefore, by preventing prostaglandin production, the gastric acids can continue to attack the mucosa lining and this can lead
to excessive bleeding enhanced by the anti–platelet properties of aspirin which further prevent clotting or even form ulcers. Problems with a bleeding

Blood Platelets
Platelets are the cells that circulate within our blood and bind together when they recognized damaged blood vessels. They are the smallest of our
blood cells, and can only be seen under a microscope. Platelets are made in your bone marrow with your white and red blood cells. They are tiny
blood cells that help your body form clots to stop bleeding. If one of your blood vessels gets damage, it sends out signals that are picked up by
platelets. Platelets rush to the damage blood vessel to stop the bleeding, by growing sticky long tentacles that help them adhere. As well as send out
chemical signals to attract more platelets to pile onto the clot in a process called aggregation. It is amazing how platelets can help our damage blood
vessels and stop bleeding, so what other ways can our platelets do for us? This is a question one researcher and his colleagues asked and put to the test.
Today many patients with solid tumors undergo surgery to have it remove, but removing the entire tumor can be challenging and somecancer cells can
remain. Dr. Gu and his colleagues wondered whether immunotherapy drugs could be targeted to the surgery site as an adjuvant therapy to help wipe
out any remaining cancer cells. To deliver the therapy, Dr. Gu sought help from platelets, because these small cell fragments accumulate in wounds and
can interact with metastatic cancer cells circulating in the bloodstream. As well as become activated at the wound site, releasing chemicals to
supplement the local immune response helping to repair the

Fibrinogen Lab Report
Fibrinogenolytic activity
Fibrinogen is a soluble, large and complex glycoprotein which helps in formation of blood clot 241. The glycoprotein has two sets of disulfide bridged
AО±, BОІ and Оі chains. Each molecule has two outer D domains which is connected to E domain (a central domain) by coiled coil segment 242–244.
The experiment was conducted to observe any effect of crude N. kaouthia venom on various chains of bovine fibrinogen. In brief, bovine fibrinogen
(2mg/ml) was dissolved in 50mM TrisHCl buffer, pH 7.4, 0.15M NaCl for overnight. Various amounts of crude venom from 1
–10Вµg in 150 Вµl of
buffer (Tris–Cl buffer, pH 7.4, 0.15M NaCl) were incubated with 300Вµl of dissolved fibrinogen for different time intervals (0, 30, 60, 120, 240, 480,
960 and 1440mins) at 37В°C 240. The collected mixtures at various time intervals were then run on a 12.5% SDS–PAGE to observe any changes in the
protein bands of fibrinogen. Staining was done with 1.2% coommassie brilliant blue R250 and destained with Methanol: Acetic acid: Water (40:10:50)
to observe any effect on the AО±, BОІ and Оі chains of bovine fibrinogen.
2.2.12 In–vitro coagulant assays
2.2.12.1 Recalcification time
Recalcification time test was performed according to ... Show more content on Helpwriting.net ...
Activated partial thrombin time was determined using APTT reagent obtained from STAGO (France) according to the manufacturers' protocol. Various
concentrations of crude N. kaouthia venom/ purified toxin (Nk–3FTx) (0.0042 to 4.2Вµg/ml) were assayed to determine its effect on APTT of
harvested PPP. The crude venom was pre–incubated with 50Вµl PBS, 50Вµl of human PPP and 50Вµl of APTT reagent for 3mins at 37oC on a
coagulation analyzer (STAGO, France). Further, 50Вµl of 0.025M CaCl2 was added to the reaction mixture to determine clot formation time. The clot
formation time with PBS was considered as normal clotting

Research Paper On Keloid
Keloids were described around 1700 BC by Egyptian Surgeon1. In 1806 Baron Jean Louis identified keloid as an entity2. Initially he called it as
'Cancroide' then changed as 'cheloide' to avoid confusion with cancer3. The word keloid is derived from Greek "chele" which means hoof/crab
pincers and "oid" means like.
Keloid scar occur as a pathological response to cutaneous injury and occur only in humans. Keloid scar grows beyond the borders of original wound
and does not regress spontaneously. It grows in Pseudo tumour fashion with distortion of lesion which recurs after excision. They are resistant to
therapy. Numerous treatment modalities are available none of them are effective.
A prototype of fibrotic skin disease is keloid. It is localized ... Show more content on Helpwriting.net ...
It occurs by two types of reaction 1)Regeneration by proliferation of residual cells and maturation of tissue stem cells. 2) Deposition of connective
tissue to form scar.27
Normal wound healing is very important in understanding the pathogenesis of keloid.It comprises three phases which are 1) Inflammatory phase
2)Fibroblastic Proliferation 3) Remodelling
After skin injury complement cascade stimulates the migration of inflammatory cells by releasing vasoactive and chemotactic mediatiors.
Macrophages plays a vital role in transition from inflammation to granulation phase by releasing cytokines. In fibroblastic phase fibroblast migrate into
the wound and produce new structural framework by deposition of type Р† and type Р†Р†Р† collagen. In maturation phase stimulatory and
angiogenetic factors decreases resulting in regression of hyperemia associated with early wound repair.
After injury Platelets adhere to the site of injury, then platelet gets activated and aggregated followed by activation of coagulation cascade and
formation of clot.28,29

Pfa 100: Platelet Function Assay
PFA–100В® Platelet Function Assay
Jennifer Dorman
I, Jennifer Dorman, have not received any unauthorized aid on this assignment.
PFA–100В® Platelet Function Assay
Equipment
The platelet function assay performed in McLendon Clinical Laboratories at UNC Hospitals utilizes the PFA–100В® system manufactured by
Siemens Healthcare, Inc. (1, 2)
Indications
The platelet function assay is a screening test for detecting platelet dysfunction during platelet plug formation in primary hemostasis. (3) This test has
replaced the invasive and unreliable bleeding time method, which was used to monitor clot formation in patients before surgical procedures. (4)
Patients can present with inherited platelet dysfunction, or most commonly, platelet ... Show more content on Helpwriting.net ...
Siemens. PFA–100В® System [Internet]. Malvem: Siemens Medical Solutions USA, Inc.; c2017 [cited 2017 Mar 24]. Available from: https:/
/usa.healthcare.siemens.com/hemostasis/systems/pfa–100
3. McLendon Clinical Laboratories. (McLendon Clinical Laboratories, UNC Hospitals at Chapel Hill). [Platelet Function Screen (PFA–PLTS);
Coagulation Clinical Rotation Handout]. 1p.
4. McKenzie SB, Williams JL. Clinical Laboratory Hematology. 3rd ed. Upper Saddle River: Pearson; 2015. p. 754–755.
5. Platelet Function Screen (PFA, PFA–100) [Internet]. Chapel Hill: McLendon Clinical Laboratories.; c2017 [cited 2017 Mar 24]. Available from:
http://www.unchealthcare.org/mclendon–clinical–laboratories/available–tests/platelet– function–screen–pfa–pfa–100/
6. Platelet Function Testing: PFA–100 [Internet]; c 2013 [cited 2017 Mar 26]. Available from: http://practical–haemostasis.com/Platelets
/platelet_function_testing_pfa100.html
7. McKenzie SB, Williams JL. Clinical Laboratory Hematology. 3rd ed. Upper Saddle

River: Pearson; 2015. p. 680–684.
8. Cristobal C. Coag Rotation Paper [Internet]. Message to: Dorman J.
2017 Mar 23 [cited 2017 Mar 25]. [1

Managing Active Hemorrhage ( Mt )
Managing active hemorrhage is a particular challenge to the anesthesiologist due to derangements in hemodynamics, coagulopathy and electrolytes.
These are further complicated by anesthesia, operational exposure and the need for intravascular volume support during resuscitation. In addition, the
anesthesiologist must attempt to prevent post–operative morbidity, especially concerning end–organ dysfunction in patients with at–risk cardiovascular,
neurovascular, pulmonary, hepatic or renal function.
With an aging population, higher use of anticoagulants and the development of novel drugs, a new degree of coagulopathy has been introduced
previously unseen in resuscitation1. Historically, initial resuscitation centered on the use of ... Show more content on Helpwriting.net ...
Trauma patients transferred from the field often receive crystalloid infusion. In an analysis of 8700 patients of the German Trauma Registry in 2006,
34% were overtly coagulopathic at the time of presentation; the degree of derangement was proportional to the degree of prior crystalloid
resuscitation4. Specifically, 10% of patients were coagulopathic after receiving 500 mL or less of crystalloid, which has been shown to be a product of
both acute trauma response and factor dilution4. In trauma, abnormal coagulation panels at the time of presentation are associated with a 3–fold
increase in mortality. Specifically, patients presenting with INR >1.5 have a mortality of 30% compared to 5% in those with normal INR4. Further
research shows that factor–depleted infusions potentiate coagulopathy of trauma5.
MT is defined as > 10 u RBC in 24 h, > 4 u RBC in 4 hours with additional anticipated need, or replacement of 50% total blood volume (TBV) in 3
hours1. Of patients admitted to a civilian level I trauma center, 1– 5% require a MT1,4. An increase in transfusion requirement is associated with
increased mortality. Patients receiving 10 u RBC1. Current evidence for MT practice stems from the past 15 years of research from military trauma
literature and has been widely accepted for use in civilian trauma, obstetric emergencies, and major surgery.
Interpreted clinically to represent impending death, the lethal triad of

Thrombocythemia Research Paper
Essential Thromboycythemia, also sometimes referred to as idiopathic thrombocythemia, essential thrombocytosis and ET, is a rare blood disorder.
Those affected with this disorder produce too many blood platelets. Platelets also known as thrombocytes are colorless blood cells that aide in the
stopping of bleeding when an injury has occurred. While the platelet counts in a person with ET are high the red and white blood cell counts of those
individuals are generally normal. Occasionally one might have a slightly elevated number of white blood cells too. Often times symptoms of
thrombocythemia will become apparent when a blood clot forms somewhere in the body. Increased number of platelets in the blood make the
propensity to form a blood clot a huge risk. Symptoms of essential thrombocythemia are largely based on where a clot may have formed in the body.
Some symptoms include but are not limited to: fatigue, headache, feelings of being lightheaded, noticeable changes in eyesight clarity, dizziness, chest
pain, erythromelagia (redness, throbbing, or burnig in the hands and feet). Some less common symptoms may also include spontaneous ... Show more
content on Helpwriting.net ...
This can happen when a blood clot forms in one of the arteries that supply blood to the brain. Strokes can result in the loss of feeling and movement
in limbs and face, memory issues, speech issues and death in some cases. ET is usually the result of a separate disease like leukemia or an immune
system disorder. ET has no cure to date, but those with mild ET may not need to seek any treatment. This disorder affects less than 1 in 100,000 in
any given year. More commonly women are diagnosed than men and individuals over the age of 50 have a higher rate of have the disorder as well
though it is not unheard of for a younger person to be diagnosed with it. Most people diagnosed tend to live a normal lifespan with proper medical
interventions and treatments when

A Study On Prevention And Treatment Of A Platelet...
Diagnosing prothrombotic diseases early and preventing its complications are significantly essential. Therefore, this study sought to investigate whether
MPV contain diagnostic value that can prompt it to be utilized as a platelet activation marker and as marker of evidence of thrombotic risk. Platelet
activation is widely acknowledged to be an indicator of likely prothrombotic diseases. Platelet size, measured as MPV, has been shown to be an
indicator of platelet function and is positively linked to platelet activity indicators (Tsiara et al., 2003). The correlation between platelet size and
function can be attributed to the larger platelets that activated megakaryocyte produce in the bone marrow likely to be more reactive and easier to
aggregate than the normal platelets. Such is because the larger platelets secret more ОІ–thromboglobulin and serotonin, have denser granules, generate
more thromboxane in comparison to the smaller platelets while also showing more activity than the smaller platelets (Dastjerdi et al., 2006).
Therefore, the hyperactive large platelets contribute considerably in speeding the formation and spread of intracoronary thrombus. This causes acute
thrombotic events to occur (Smith et al., 1999). Increased MPV levels are exhibited to constitute an independent predictor for recurrent MI, ischemic
vascular events or even death caused by coronary artery disease (Wang et al., 2011; Chu et al., 2010; Huczek et al., 2005). Dogan et al. (2012) linked
MPV

Essay On Wound Regeneration
The greatest challenge in clinical research trials is the development of bioactive surgical additives to reduce the post operative signs and symptoms by
regulating inflammation and increase the speed of healing process. [1] An extensive intra cellular and extra cellular set of event are carried out in the
healing of soft and hard tissue which are medicated by signalling proteins. [2]Yet complete self–regeneration in many tissues and organs after injury is
limited. In endogenous regenerative medicine, tissue recovery is stimulated by blood plasma, growth factors and cytokines from platelets. [3, 4] Several
studies are focusing on the development of innovative technologies for tissue regeneration based on the use of different graft ... Show more content on
Helpwriting.net ...
PRP is the precursor of another autologous derivates, the platelet–rich fibrin (PRF), a solid fibrin–based biomaterial. [13]
A recent classification divided plasma concentrates into four different categories depending on their leukocytes and fibrin content: pure platelet–rich
plasma (P–PRP), such as cell separator PRP, Vivostat PRF or Anitua's PRGF; leucocyte
– and platelet–rich plasma (L–PRP), such as Curasan, Regen,
Plateltex, SmartPReP, PCCS, Magellan or GPS PRP; pure plaletet–rich fibrin (P–PRF), such as Fibrinet and leucocyte– and platelet–rich fibrin
(L–PRF), such as Choukroun's PRF. This classification helps to analyse the successes and failures that have occurred so far in oral surgery, and direct
research towards further applications of these technologies in daily clinical practise. [14–16]
PLATELET RICH FIBRIN:
Platelet–rich fibrin (PRF) is an autologous biomaterial which is the second generation of platelet concentrates. It is the successor of platelet–rich
plasma (PRP), having multiple benefits [17]. The benefits of working with PRF are quicker preparation, availability for every patient and minimal
trauma. Several works related to the issue of the use of PRP and PRF in periodontal, oral, maxillofacial and plastic surgery as well as in
otorhinolaryngology have been published [18]. Some of the application in oral and maxillofacial are: sinus augmentation after maxillary sinus floor

Platelet Confusion
Platelet transfusion
There is no fixed platelet count threshold in ICU patients that signals platelet transfusion (93), but because of hemorrhage fear there is a widespread
notion that the platelet count should be maintained over 100X109/L in massive bleeding or when bleeding occurs at dangerous sites such as in
intracranial hemorrhage (94).
In addition to platelet count, the risk of hemorrhage is also dependent on the hematocrit and the bleeding time (95). So, red blood cell transfusion should
also be considered as a part of a supportive therapy, if needed (17).
Despite these recommendations, it should be born in mind that platelet transfusion is not a risk–free procedure and may cause several potentially fatal
complications such as contamination,

Mediated Clot Reaction Process
Differences in the integrin О±IIbОІ3–mediated clot retraction process between PECAM–1–/– and wild–type platelets
At the experiment outset, the PECAM–1 deficient mouse population was healthy and displayed normal Mendelian inheritance ratios.12 In addition, the
population was within a haematologically normal range and displayed normal platelet production.12 During the first months of life, when compared to
the age–and sex–matched population of wild mice, the homozygous PECAM–1 knockout mouse population struggled to grow, with lower average
body weights.17 Research performed by Mahooti et al,18 which assessed tail bleeding duration, suggested that the PECAM–1–/– group displayed
longer bleeding times and, therefore, an in–vivo bleeding defect. In sharp contrast, similar research by Vollmar et al19 suggested that the PECAM–1
deficient population displayed normal tail bleeding times. Initially, it was proposed that the potential reason for this difference was an artefact created
by different experimental techniques. Further investigation, using hematopoietic reconstitution of irradiated PECAM–1–/– mice to evaluate any
reversal of prolonged tail bleeding, showed that the discrepancy was probably caused by an underlying endothelial defect rather than a platelet defect.18
In vitro evidence suggested that modulation of integrin О±IIbОІ3–mediated functions was influenced by engagement of the PECAM–1 group, so the
next stage involved testing if a fundamental integrin О±IIbОІ3 platelet

Disadvantages Of Hemostatic Dressings
CHAPTER 1
INTRODUCTION
According to World Health Organisation (WHO), on an average, motor vehicle crashes have killed about 1.25 million people every year and also it
has been observed that 90% of the world's fatalities on the roads occur in low–income and middle–income countries. India accounts for about 10% of
road crash fatalities worldwide [45]. The control of hemorrhage (massive bleeding) is a critical step in first aid and field trauma care. This control is
essentially done by applying pressure, elevation of bleeding site, usage of elastic field dressings, tourniquets and novel haemostatic dressings [29].
Among these methods, hemostatic dressings are used as last alternative, but it is the resourceful system of all. In this report, various forms of
hemostatic materials and the products available in the market are reviewed.
Fig 1: A simplified hemorrhage control algorithm [31]
An ideal hemostatic dressing must have the subsequent characteristics: [29, 38]
Biocompatible, biodegradable and bio absorbable
Ease of storage
Easily removed without leaving residues
Easy administration
Flexible enough to fit complex wounds
Long shelf life, lightweight
Low cost
No adverse effects to healing
No thromboembolic complications
Prolonged stability even ... Show more content on Helpwriting.net ...
American Red Cross Holland Laboratory, Rockville, MD) consists of higher concentrations of human fibrinogen, human thrombin and calcium chloride
affixed in a mesh. These agents were in increasingly used at the end of World War II but fell out and were consequently abandoned due to the
transmission of hepatitis. It was re–visited again in the early 1990s by the US Army and the Red Cross to assist in hemostasis. Although not approved
by the US Food and Drug Administration, it was used under an investigational drug protocol by US forces in Iraq and Afghanistan and has proven to
be successful in combat because of its simple application, stability, and bio absorbability

Platelets Play a Large Role in Tissue Regeneration and...
Unlike other blood cells, platelets are small anucleate structures derived from marrow megakaryocytes and thought for almost a century to possess
solely hemostatic potentials. Platelets, however, play a much wider role in tissue regeneration and repair and interact intimately with tumor cells.
On one hand, tumor cells induce platelet aggregation [TCIPA] known to act as the trigger ofcancer associated thrombosis and on the other, recruited to
the tumor microenvironment platelets interact directly with tumor cells favoring their proliferation and indirectly through the release of a wide palette
of growth factors, angiogenic and mitogenic proteins. The role of platelets is not only confined to the primary tumor site. They escort tumor cells
helping their intravasation, vascular migration and extravasation to the tissues forming distant metastasis.
As expected, non–specific or specific inhibition of platelets and their contents represents an attractive approach in the fight against cancer.
The current review illustrates the role played by the platelets at primary tumor sites and in the various stages of the metastatic process.
Key Word: Tumor, Cancer, Platelet, TCIPA, Growth factor, Metastasis
HISTORIC BACKGROUND
In 1877, Hayem provided a firm histologic basis for platelets; albeit he felt they were the origin of red blood cells and referred to them as
"hematoblasts". Bizzozero, in 1882, introduced the term "blood plates" and documented their importance in blood

The History Of Hemophilia A / B, Inheritance Patterns, And...
Genes are constructed from deoxyribonucleic acid, otherwise known expressed as DNA, and are the building blocks for the proteins allowing an
organism's body to function properly. Genes are the backbone that determines what the human body will have the potential to become, acting an
instruction manual, concerning their genetic disease susceptibility. With genes developing the proteins necessary for survival come the establishment
of the basic building blocks of life recognized as the cell. The human body has an assortment of roughly trillions of cells each assigned a specific
function derived from the genes that have been given them instruction by DNA providing the genetic mapping. This research paper's focus is on the
history of... Show more content on Helpwriting.net ...
Throughout the progression of its identification it has been known as the royal disease due to its prominence among the descendants of Queen Victoria
(1819–1901) as she was a carrier for the gene and the beginning of hemophilia notable X–linked recessive presence in Europe. The distinction of the
royal diseases presence in Europe was due to the inbreeding between royal members in order to maintain strategic diplomacy. The term hemophilia
itself was finally coined by Hopff in 1828 at the University of Zurich after being discovered and described by Dr. John Conrad Otto in 1803.
Hemophilia A and Hemophilia B are inherited bleeding conditions where theblood does not properly coagulate (Center for Disease Control and
Prevention 2014)2. The inheritance of hemophilia progresses through a carrying of the gene inflicted and is passed on via mother to child at the time
of conception. X and Y chromosomes are distinguished as being the sex hormones of the human body. Hemophilia–A in a sex–linked recessive trait
disorder located on the X chromosome and otherwise absent on the Y chromosome. Being that it is located only on the X chromosome, if a son is
conceived carrying the gene the disorder will inevitably develop. While in the case of females, for the disease to manifest the carrier for the gene must
be on both X chromosomes which is noted to be more. Though most hemophilia diagnosis are associated with males, the chance for the inheritance

Hemostasis Essay
Hemostasis is the stoppage of blood flow. In order to do this our body's rely on an "adequate amount of platelets, normal levels of coagulation factors,
and absence of defects in vessels walls" (Huether and McCance 540).
In platelet disorders both quantitative and qualitative factors can interrupt normal blood coagulation which prevent hemostasis (Huether and McCance
541). Quantitative abnormalities in a platelet disorder would be an increase or decrease in the number of platelets disorders that are involved with this
issue are thrombocythemia and thrombocytopenia (Huether and McCance 540). Thrombocythemia is an increase in the number of platelets and
thrombocytopenia is a decrease in the number of platelets (Huether and McCance 541). Qualitative disorders would be anything that would prevent the
formation of a platelet plug by preventing adherence and aggregation (Huether and McCance 541). ... Show more content on Helpwriting.net ...
"Qualitative or quantitative abnormalities interfere with or prevent enzymatic reactions that transform clotting factors, circulating as plasma
proteins into a stable fibrin clot" (Huether and McCance 544). Some defects are caused by a single factor, these would be hemophilias and von
Willebrand disease and some are acquired and result from "deficient synthesis of clotting factors by the liver" which is caused by liver disease and
vitamin K deficiency (Huether and McCance 544). Other abnormalities in coagulation disorders are caused by "pathologic conditions" such as a
cardiovascular abnormality that alters blood flow. An example of this is thromboembolic disease where blood clots block vessels (Huether and
McCance 544). Vasculitis and damage to vessels activates platelets which activates coagulation (Huether and McCance 544). Prolonged vasculitis leads
to clogging of the

Immune Thrombocytopenic Purpura (IPT)
When I was five, my parents started noticing weird bruises all over my body. They would ask me what I was doing that gave me so many bruises; I
never knew what it was. (1: SV; SV.) Finally, my parents took me into the doctor after months of noticing these strange bruises. The doctors ran many
tests and took a lot of blood. I was diagnosed with chronic Immune Thrombocytopenic Purpura, otherwise known as ITP. ITP is an auto–immune blood
disorder that is caused by an untreated viral infection or immune system suppression caused by vaccinations and can be life–altering. Symptoms of ITP
can range dramatically from patient to patient. One of the many symptoms is low blood platelet count. Blood platelets are important for the body: they
essentially form clots in the blood to stop bleeding. (3: SV: SV.) According to Michael A. Silverman, author of the article "
Idiopathic Thrombocytopenic
Purpura" posted on Medscape, "Relative marrow failure may contribute to this condition, since studies show that most patients have either normal or
diminished platelet production" (1). In other words, a delayed making of marrow is present in most patients with ITP and aids in this disease. Because
of this, blood platelets cannot be made as accurately as a normal body would make them. Other symptoms include easy bruising and petechiae
(Idiopathic 1). Easy bruising can result from blood vessels becoming weak; consequently, the slightest touch can break them, forming a bruise. (1a: SV;
consequently,

Case Study Of Azathiopidia With Lupus
Amegakaryocytic thrombocytopenia is a rare complication of Systemic Lupus Erythematosus (SLE) with occasional reports of successful treatment
with Cyclosporine, Rituximab, and Eltrombopag. Both humoral and T–cell mediated mechanisms have been implicated in impaired thrombopoiesis
with the setting of lupus. We report glucocorticoid refractory amegakaryocytic thrombocytopenia successfully treated with Azathioprine (AZA) in a
middle–aged lady with lupus. To our knowledge, this is the first reported case of successful use of Azathioprine in SLE–related amegakaryocytic
thrombocytopenia.
Case Report:
A 48–year–old lady presented to us with inflammatory polyarthralgia of the small and large joints. She had a history notable for low–grade fever ...
Show more content on Helpwriting.net ...
However, Bone marrow biopsy revealed reduced megakaryocytes with preserved erythroid and myeloid precursors, and plasma cell infiltrates in the
interstitium. Based on these findings, a diagnosis of amegakaryocytic thrombocytopenia was reached and intravenous methylprednisolone was initiated
to which she had mild and ill–sustained response. Intravenous immunoglobulin was administered, with the successful rise in platelet counts to 80,000
/mm3. The choice of another agent for maintenance immunosuppressive therapy was the prime concern. Literature on amegakaryocytic
thrombocytopenia in lupus is limited to few case reports of successful use of Rituximab, cyclosporine and thrombopoietin (TPO) receptor agonists
(Eltrombopag).1–3 The presence of CKD precluded the use of CSA in our patient. RTX would take longer to act and Eltrombopag could not be given
due to financial constraints. Hence, she was initiated on azathioprine at a dose of 25 mg/day that was gradually escalated to 2.5–mg/kg body weight
(125 mg/day) with weekly monitoring of white cell counts. Platelet counts exhibited rising trends over the next two weeks and subsequently stabilized
in the normal range after two months of AZA. The patient has been doing well on the drug over the past three years without flares or new organ
involvement. To our knowledge, this is the first report of successful use

The Role Of Idiopathic Trombocytopenic Pumpune Responses

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The Role Of Idiopathic Trombocytopenic Pumpune Responses