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The original articles Hemostatic derangements in patients with solid malignant tumors Mazin R.
Mohammed1, Saad S. Mansoor1, Mustafa Ghany Taher2 1. Baqubah Teaching Hospital, Diyala, Iraq 2. Cancer patients show an increased susceptibility to thromboembolic diseases. Although clinical symptoms occur less frequently, disorders of coagulation are very common in cancer patients. The aim of the study was to determine the presence of hemostatic derangements in patients suffering from solid malignant tumors. This case-controlled study was conducted on patients with solid malignant tumors who presented to Al-Yermok Teaching Hospital and Hospital of Radiation and Nuclear Medicine in Iraq, from January to July Forty cases were included in the study and the control group included fifteen age and gender matched healthy volunteers.
Platelet count was determined from blood sample, while tests for prothrombin time PTactivated partial thromboplastin time aPTTthrombin time TTfibrinogen and D-dimer were conducted on plasma. Fourteen patients had slight concurrent bleeding; only one patient gave history of recurrent attacks of deep venous thrombosis. The mean PT, aPTT and TT were higher in subjects with malignancies as compared to the healthy controls; and these variables were also higher in those with evidence of uterine cancer diagnosis stories coagulation and fibrinolysis ICF as compared to those without ICF uterine cancer diagnosis stories.
Hemostatic derangement is common in patients with a wide variety of malignancies. The plasma D-dimer test with other indices of DIC syndrome forms a good and simple applicable panel of tests for assessment of ICF syndrome. Keywords: Hemostatic derangement; Solid malignant tumor; D-dimer Introducere. Pacienţii cu cancer prezintă o susceptibilitate crescută pentru dezvoltarea bolilor tromboembolice. Deși simptomele clinice apar mai rar, problemele de coagulare uterine cancer diagnosis stories foarte comune în rândul pacienţilor cu cancer.
Scopul studiului a fost să determine prezenţa afecţiunilor hemostatice la pacienţii care prezintă tumori maligne solide. Acest studiu caz-control a fost realizat cu participarea pacienţilor cu tumori maligne solide care s-au prezentat la Spitalul Universitar Al-Yermok și la Spitalul de Iradiere și Medicină Nucleară din Irak, între ianuarie și iulie Patruzeci de cazuri au fost incluse în acest studiu, iar grupul de control a fost format din 15 voluntari sănătoși ajustaţi pentru vârstă și sex.
Paisprezece pacienți au prezentat sângerare concomitentă ușoară; doar un singur pacient a prezentat un istoric de tromboză venoasă recurentă. Media PT, aPTT și TT a fost mai mare la subiecţii cu cancer în comparaţie cu subiecţii de control; aceste variabile au fost de asemenea mai ridicate la cei cu fibrinoliză și coagulare intravasculară Uterine cancer diagnosis stories în comparaţie cu cei fără sindromul ICF. Afectările hemostatice sunt comune în cazul unei varietăţi de malignităţi.
Testul pentru D-dimeri împreună cu alţi indici ai sindromului DIC formează un bun panel de teste de laborator pentru diagnosticul sindromului ICF.
Cuvinte-cheie: afectare hemostatică, tumori maligne solide, D-dimer Introduction Patients with solid malignant tumor show an increased susceptibility to thromboembolic events as compared to the general population.
Although clinical 14 symptoms occur less frequently, disorders of coagulation are very common in such patients 1. Thromboembolism is one of the most uterine cancer diagnosis stories causes of death in cancer patients 1.
The incidence of TED in postmortem studies of cancer patients is considerably higher. A wide range of coagulation disturbances can occur in patients with malignancies, which can predispose patients to hemorrhage or thrombosis 6.
Cooper and associates classified this syndrome into three groups; decompensated which is defined by depressed platelets or fibrinogen levels along with other hemostatic abnormalities, compensated in which platelets or fibrinogen values are normal but other hemostatic tests are uterine cancer diagnosis stories prolonged, and overcompensated whereas the platelets or fibrinogen are increased together with other hemostatic abnormalities.
This has also been correlated with the conventional terms; acute, sub-acute and chronic DIC with decompensated, overcompensated and compensated DIC respectively 7,8. The aims of the study were to uterine cancer diagnosis stories the presence of hemostatic derangements in patients suffering from solid malignant tumors.
Uterine cancer diagnosis stories secondary aim was to elucidate the association of intravascular coagulation and fibrinolysis ICF with grade of tumor, histologic type of tumor and presence of metastasis. Methods and materials This case-controlled study was conducted during a period of six months, from January to July A total of 40 patients with solid malignant tumors of various organs were included in this study; 13 of these patients were admitted to Al-Yermok Teaching Hospital in Uterine cancer diagnosis stories and 27 patients were from the Hospital of Radiation and Nuclear Medicine in Baghdad.
Fifteen age and sex matched healthy volunteers were included in this present study as control group, 9 males and 6 females, the age range was years for males and years for females.
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We excluded patients with co-morbid conditions that could affect coagulation profile, or patients using certain medication or those with history of coagulation disorders. The platelet count was conducted on blood whereas plasma was isolated for remaining laboratory tests including prothrombin time PTactivated partial thromboplastin time aPTTthrombin time TTfibrinogen and D-dimer.
Patients were considered to have evidence of intravascular coagulation and fibrinolysis ICF syndrome if their plasma D-dimer level was more than 0. The concept of ICF of Owen and Bowie was adopted and their classification of overcompensated, compensated and decompensated ICF was tested 8,9 and an attempt was made to identify those key tests that might enable us to discover patients with coagulation problems.
The D-dimer and platelets were used as indicators and separated the patients into four groups. Patients with no ICF normal D-dimer 2. Those with overcompensated ICF elevated D-dimer and elevated platelets count 3. Those with compensated ICF elevated D-dimer but normal platelets count 4.
Those with decompensated ICF elevated D-dimer uterine cancer diagnosis stories decreased platelets count. In this study, the FDP test which was used by Owen and Bowie study 7 has been replaced by D-dimer test for the diagnosis of ICF syndrome because the D-dimer test is regarded now to be more specific for fibrin degradation products whereas the formation of fibrinolytic degradation products FDPX, Y, D and E fragments may be either fibrinogen or fibrin derived following uterine cancer diagnosis stories plasmin digestion 9, Moreover, the criteria of Owen and Bowie for the diagnosis of ICF was utilized, although in recent years many new criteria were added to diagnose ICF 11,12,13 but none of these were applicable in the present study because of the non-availability of some of relevant laboratory tests.
Pooled plasma from at least 4 healthy individuals, were prepared and divided into Hodgkin uterine cancer diagnosis stories.