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Plaque erosion, a type of coronary atherothrombosis, involves superficial injury to smooth muscle cell (SMC)-rich plaques. Elevated levels of coagulation factor VIII (FVIII) correlate with an increased ischemic heart disease risk. FVIII may contribute to thrombus formation on eroded plaques. We aimed to elucidate the role of elevated FVIII in arterial thrombus formation within SMC-rich neointima in rabbits. We assessed the effect of recombinant human FVIII (rFVIII) on blood coagulation in vitro and platelet aggregation ex vivo. An SMC-rich neointima was induced through balloon injury to the unilateral femoral artery. Three weeks after the first balloon injury, superficial erosive injury and thrombus formation were initiated with a second balloon injury of the bilateral femoral arteries 45 min after the administration of rFVIII (100 IU/kg) or saline. The thrombus area and contents were histologically measured 15 min after the second balloon injury. rFVIII administration reduced the activated partial thromboplastin time and augmented botrocetin-induced, but not collagen- or adenosine 5′-diphosphate-induced, platelet aggregation. While rFVIII did not influence platelet-thrombus formation in normal intima, it increased thrombus formation on SMC-rich neointima post-superficial erosive injury. Enhanced immunopositivity for glycoprotein IIb/IIIa and fibrin was observed in rFVIII-administered SMC-rich neointima. Neutrophil count in the arterial thrombus on the SMC-rich neointima correlated positively with thrombus size in the control group, unlike the rFVIII group. Increased FVIII contributes to thrombus propagation within erosive SMC-rich neointima, highlighting FVIII's potential role in plaque erosion-related atherothrombosis. • Recombinant VIII (rFVIII) does not affect thrombus formation on normal intima. • rFVIII enhances platelet-fibrin thrombus on smooth muscle cell-rich neointima. • Enhanced thrombosis under elevated FVIII is neutrophil-independent. [ABSTRACT FROM AUTHOR]

Background: Unfractionated heparin (UFH) is a high-risk medication that can cause bleeding and/or thrombotic complications if not managed appropriately. Between January and July 2019, our institution experienced a high number of patient safety events related to UFH infusion for the treatment of venous thromboembolism (VTE). Purpose: The aim of this quality improvement (QI) initiative was to prevent these safety events by improving compliance with our institution's nurse-driven VTE UFH infusion protocol. Methods: Baseline data for patients on the VTE UFH protocol were collected to identify improvement opportunities. Compliance with eight standards of care related to the VTE UFH infusion protocol was measured. Time to first therapeutic activated partial thromboplastin time (aPTT) was recorded to assess the benefit of improved compliance. Interventions: Institutional policy updates were made to clarify the management of UFH infusions and documentation in the electronic health record. A multidisciplinary workgroup implemented order set changes, nursing communication orders, UFH infusion reports, and a nursing education module to promote compliance with the protocol. Results: The overall rate of compliance with the VTE UFH infusion protocol increased from 79.4% at baseline to 85.2% following implementation of the QI initiative, and the median time to first therapeutic aPTT decreased from 831.5 minutes to 808 minutes over the same period. Conclusions: A multidisciplinary initiative to address improvement opportunities in a nurse-driven UFH protocol for VTE treatment increased compliance with the protocol and decreased the time to first therapeutic aPTT. The authors describe a quality improvement initiative to reduce patient safety events related to unfractionated heparin (UFH) infusions by increasing compliance with their institution's venous thromboembolism UFH protocol. [ABSTRACT FROM AUTHOR]

Recent studies have suggested the use of insects to enhance various bioactivities in the treatment of many diseases or as alternative sources of nutrients. White‐spotted flower chafer (Protaetia brevitarsis seulensis; PBS) extract, which is used for medicinal purposes, appears to be effective in improving blood circulation. However, few studies have investigated the efficacy of PBS extract in improving blood circulation. Here, we investigated the effects of PBS extract on serum cholesterol metabolites (total cholesterol, high‐density lipoprotein cholesterol, and low‐density lipoprotein cholesterol) and anticoagulant activities (prothrombin time [PT], activated partial thromboplastin time [aPTT], and fibrinogen [Fib]) in very‐high‐fat diet (VHFD)‐induced hyperlipidemic rats. The experimental groups comprised a control group that was not treated with PBS and five PBS treatment groups (50, 100, 150, 200, and 250 mg/kg) in a randomized complete block design. In the efficacy evaluation for health functionality to reduce cholesterol levels, no beneficial effects on serum cholesterol metabolites were observed in the control and PBS treatment groups. In addition, the cholesterol data indicated that the effect of the PBS extract was not related to antioxidant activity. Moreover, the PT, aPPT, and Fib values were prolonged by increasing the PBS extract concentration, and PBS extract concentrations of 150–250 mg/kg were recommended for the VHFD model based on the anticoagulant activity. In conclusion, the PBS extract can be used in a potential therapeutic strategy for improving anticoagulant activity rather than improving the serum cholesterol profile. [ABSTRACT FROM AUTHOR]

Introduction: The Thai National Guidelines for Hemostatic Laboratory Testing were established in 2018. The guidelines recommend that the 20‐min whole blood clotting time (20WBCT) method be used to diagnose/monitor snake bites. The aim of this study was to survey members of the Thailand National External Quality Assessment Scheme (NEQAS) for Blood Coagulation to investigate the use of 20WBCT testing compared between the 2021 post‐guideline and 2007 pre‐guideline periods. Methods: In July 2021, questionnaires were sent from the Faculty of Medicine Siriraj Hospital, Mahidol University to 521 Thailand NEQAS for Blood Coagulation member laboratories to survey their WBCT practices. Current WBCT practices were compared with pre‐guideline WBCT practices, and chi‐square test (x2) was used to test for differences between groups. Results: Ninety‐seven (18.6%) of 521 surveys were returned. Seventy‐one laboratories (73.2%) reported knowing about 20WBCT from the Thai national guidelines. The reported average frequency of overall WBCT testing in 2021 was 12.4 times/month. The proportion of laboratories that reported using the 20WBCT test increased from 2.0% in 2007 to 46.4% in 2021 (p < 0.001), and the indications for performing WBCT were virtually unchanged from 2007 to 2021. The proportion of laboratories that reported having problems with WBCT testing decreased from 32.7% in 2007 to 16.5% in 2021. Conclusion: Despite our findings that almost three‐quarters of respondent laboratories reported knowing about 20WBCT testing from the WBCT guidelines, and that WBCT‐specific problems decreased significantly from 2007 to 2021, more work and training is needed to improve WBCT guideline dissemination, understanding, and adherence in Thailand. [ABSTRACT FROM AUTHOR]

Introduction: Dilute Russell's viper venom time (dRVVT) and activated partial thromboplastin time (APTT) are the mainstay assays in lupus anticoagulant (LA) detection yet they have limitations, particularly in relation to interferences and specificity. The recently validated Taipan snake venom time (TSVT) screening with ecarin time (ET) confirmatory assays overcome many of those limitations due to the innate specificity engendered from direct prothrombin activation, and insensitivity to the effects of vitamin K antagonists (VKA). The present study aimed to further evidence diagnostic utility of TSVT/ET by performing them in samples from 116 nonanticoagulated patients with established triple‐positive antiphospholipid syndrome (APS). Methods: Samples were identified in three expert centres who performed dRVVT, APTT and solid phase antiphospholipid antibody assays with reagents from a variety of manufacturers. All samples additionally received TSVT/ET analysis using standardised reagents. Results: Ninety seven of 116 (83.6%) were dRVVT‐ and APTT‐positive, 85/97 (87.6%) of which were TSVT/ET‐positive, 9/116 (7.8%) were dRVVT‐positive only, 6 of which were TSVT/ET‐positive, and 10/116 (8.6%) were APTT‐positive only, 5 of which were TSVT/ET‐positive. 96/116 TSVT/ET‐positivity returned a high sensitivity for LA of 82.8%. Low coefficients of determination revealed weak relationships between LA potency and anticardiolipin and anti‐β2‐glycoprotein I antibody titres for all three LA assays. Conclusions: TSVT/ET has high sensitivity for the clinically significant LA found in triple positive APS patients. TSVT/ET can establish multiple LA assay positivity in nonanticoagulated patients negative for one of dRVVT or APTT, and is the only assay pairing insensitive to VKAs, the recommended anticoagulation for APS. [ABSTRACT FROM AUTHOR]

The blood coagulation test is an indispensable test for monitoring the blood coagulation and fibrinolysis functions. Currently, activated partial thromboplastin time (APTT) is the most widely used approach to coagulation testing. However, APTT reagents need to be optimized due to the fact that they are unstable, highly variable, and cannot be easily controlled. In this study, we created apoptotic cell-inspired methacryloyloxyethyl phosphorylserine (MPS) particles for blood coagulation as an alternative to conventional APTT reagents. Particle size could be controlled by changing the concentration of the polymer. The blood coagulation ability of particles was stable at different environmental temperatures. Moreover, the procoagulant activity could be enhanced by increasing the concentration to 0.06 mg/mL and reducing the size of the particles to around 900 nm. Fibrin clotted by particles showed no significant difference from that formed by APTT regent Actin FSL. We propose that MPS particles are a potential alternative to Actin FS for the application of blood coagulation tests. [ABSTRACT FROM AUTHOR]

Objective: Home healthcare services play a crucial role in reducing health expenditure, providing tailored care, and improving the quality of healthcare, particularly for managing chronic diseases. Methods: This retrospective cross-sectional study analyzed the blood test and laboratory results of 1,461 patients who were evaluated by the home health services unit in Ankara between May 1, 2020, and July 31, 2020. The patients' ages, genders, and laboratory data were collected, and statistical analyses were performed using SPSS software. A p-value of <0.05 was considered statistically significant. Results: The study included 1,461 patients, of whom 64.06% were female and 35.94% were male. Significant age differences were observed among the patients (p<0.001). Home visits were conducted for medical examinations and laboratory tests, and the results showed age-related variations in several parameters, such as albumin, alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase, creatine-kinase, gamma-glutamyl transferase (GGT), calcium (Ca), free triiodothyronine, free thyroxine, total protein, triglycerides, prothrombin time, activated partial thromboplastin time, urea, uric acid, creatinine, and potassium. Gender differences were also observed, with varying levels of amylase, activated partial thromboplastin time, ALT, total bilirubin, direct bilirubin, GGT, C-reactive protein, albumin, phosphorus, high-density lipoprotein cholesterol, Ca, and unsaturated iron binding capacity. Conclusion: Considering age-related laboratory test results is crucial in home healthcare settings. [ABSTRACT FROM AUTHOR]

The study focused on analyzing the antioxidant properties of extracts from red palm weevil larvae Rhynchophorus ferrugineus, obtained using hexane, n-butanol, dichloromethane, and diethyl ether. Additionally, the anticoagulant effects of these extracts were evaluated through activated partial thromboplastin time (APTT) and prothrombin time (PT) assays. Results showed that the hexane, n-butanol, dichloromethane, and diethyl ether extracts from Rh. ferrugineus larvae exhibited antioxidant activity comparable to ascorbic acid, with IC50 values of 142.67, 122.24, 231.77 and 74.95 µg/ml, respectively, compared to 3.16 µg/ml for ascorbic acid. Also, the anticoagulant activity of Rh. ferrugineus (larvae) tested extracts using APTT assay showed 33.8, 44.3 and 50.9 sec. At 25, 50 and 75 µg/ml of hexane extract, respectively. Meanwhile, Rh. ferrugineus n-butanol extract recorded 46.9, 57.2 and 65.5 sec. At the same concentrations. Also, dichloromethane and diethyl ether recorded anticoagulant activity reached 31.2, 40.6, 48.7 and 44.3, 52.9, 62.1 sec. at 25, 50 and 75 µg/ml, respectively, vs. 59.8, 86.2 and 109.7 sec. For the Heparin sodium salt, use the same concentrations. Generally, all Rh. ferrugineus larval extracts tested proved to be antioxidant agents. The anticoagulant potential of Rh. ferrugineus tested extracts were weaker than those of heparin and needed more concentration to reach the commercial anticoagulant (Heparin sodium salt) in both assays (APTT and PT). [ABSTRACT FROM AUTHOR]

Lupus anticoagulant hypoprothrombinemia syndrome (LAHPS) is a rare entity characterized by the presence of lupus anticoagulant (LA) and prothrombin (factor II) deficiency. It may cause severe bleeding contrary to classical antiphospholipid syndrome. Here, we report a case of LAHPS presenting with a hemorrhagic ovarian cyst in a 17-year-old girl with systemic lupus erythematosus (SLE) nephritis. She had been followed up for 8 years. Her first manifestation of SLE was prolonged gingival bleeding after tooth extraction at 9 years of age. During the follow-up period, she had neither severe bleeding nor thrombotic complications despite a positive LA and a prolonged activated partial thromboplastin time (aPTT). At this visit, the patient presented with colicky abdominal pain, a hemorrhagic ovarian cyst, a prolonged prothrombin time, a prolonged aPTT, a low factor II level, and a positive LA, leading to the diagnosis of LAHPS. While a hemorrhagic ovarian cyst resolved completely in 3 months, she received oral pill, transfusions of red blood cells and plasma, and intravenous cyclophosphamide pulse therapy in combination with glucocorticoids due to persistent menorrhagia, anemia, prolonged aPTT, and lupus flaring. Thus, LAHPS needs to be considered in SLE patients with positive LA and prolonged aPTT. [ABSTRACT FROM AUTHOR]

The toxicity of inhaled particulate air pollution perseveres even at lower concentrations than those of the existing air quality limit. Therefore, the identification of safe and effective measures against pollutant particles‐induced vascular toxicity is warranted. Carnosol is a bioactive phenolic diterpene found in rosemary herb, with anti‐inflammatory and antioxidant actions. However, its possible protective effect on the thrombotic and vascular injury induced by diesel exhaust particles (DEP) has not been studied before. We assessed here the potential alleviating effect of carnosol (20 mg/kg) administered intraperitoneally 1 h before intratracheal (i.t.) instillation of DEP (20 μg/mouse). Twenty‐four hours after the administration of DEP, various parameters were assessed. Carnosol administration prevented the increase in the plasma concentrations of C‐reactive protein, fibrinogen, and tissue factor induced by DEP exposure. Carnosol inhibited DEP‐induced prothrombotic effects in pial microvessels in vivo and platelet aggregation in vitro. The shortening of activated partial thromboplastin time and prothrombin time induced by DEP was abated by carnosol administration. Carnosol inhibited the increase in pro‐inflammatory cytokines (interleukin‐6 and tumor necrosis factor α) and adhesion molecules (intercellular adhesion molecule‐1, vascular cell adhesion molecule‐1, E‐selectin, and P‐selectin) in aortic tissue. Moreover, it averted the effects of DEP‐induced increase of thiobarbituric acid reactive substances, depletion of antioxidants and DNA damage in the aortic tissue. Likewise, carnosol prevented the decrease in the expression of nuclear factor erythroid 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1) caused by DEP. We conclude that carnosol alleviates DEP‐induced thrombogenicity and vascular inflammation, oxidative damage, and DNA injury through Nrf2 and HO‐1 activation. [ABSTRACT FROM AUTHOR]

Sudden deafness poses a significant threat to patients' quality of life, yet effective indicators for evaluating its onset and prognosis remain elusive. The inner ear is primarily supplied by the labyrinthine artery, which lacks collateral circulation. Changes in coagulation function and hemorheology can cause spasm or thrombosis of the labyrinthine artery, leading to ischemia, hypoxia, and microcirculation disorders in the inner ear, ultimately resulting in sudden deafness. This retrospective study examined 196 patients with sudden deafness, utilizing the 2015 Chinese guideline for diagnosis and treatment classification. Coagulation system analysis used the STA-R Evolution automatic coagulation analyzer, measuring activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB). Plasma lactate concentration was determined using a Johnson and Johnson Fusion 5.1 model plasma lactate detector. Results of the study revealed a correlation between the degree of hearing loss and disease prognosis. Patients with higher grade hearing loss exhibited elevated plasma lactate levels upon admission compared with those with lower grade hearing loss. Importantly, elevated plasma lactate levels at admission served as predictive indicators for treatment outcomes. In addition, patients with ineffective treatment demonstrated a more coagulable blood state, as evidenced by the lower APTT (ineffective treatment: 31.47 ± 4.55 seconds, effective treatment: 35.17 ± 5.38 seconds) and PT on admission, but higher plasma FIB. In conclusion, plasma lactate levels upon admission hold promise as prognostic markers for sudden deafness treatment outcomes, providing valuable insights for clinical management. [ABSTRACT FROM AUTHOR]

Aim To assess the association of single nucleotide polymorphisms (SNPs) in the ACE2 and TMPRSS2 genes with COVID-19 severity and key biomarkers. Methods The study involved 750 COVID-19 patients from Bosnia and Herzegovina, divided into three groups: mild, moderate, and severe cases. Genetic variations within the ACE2 (rs2285666) and TMPRSS2 (rs2070788) genes were examined with real-time polymerase chain reaction. Biochemical markers were determined with standard procedures. Results There was a significant difference in the rs2070788 genotype distribution between patients with mild and moderate symptoms, but not between other groups. For the rs2285666 polymorphism, no significant difference in genotype distribution was found. In patients with mild symptoms, carriers of the GG genotype of rs2070788 had significantly higher total bilirubin levels than carriers of the AA genotype. Similarly, carriers of the TT genotype of rs2285666 had significantly higher activated partial thromboplastin time and international normalized ratio, and lower lactate dehydrogenase levels compared with the CC genotype. Among patients with severe symptoms, carriers of the GG genotype showed significantly higher potassium levels than carriers of the AA genotype, while carriers of the TT genotype showed significantly higher erythrocyte count as well as hemoglobin and hematocrit levels compared with the CC genotype. Conclusion This study highlights the role of genetic factors, particularly SNPs in the ACE2 and TMPRSS2 genes, in determining COVID-19 severity, aiding patient risk assessment and prognosis. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the hemostatic effect of different application methods and time of tranexamic acid (TXA) on primary unilateral total hip arthroplasty. Methods: A total of 126 patients with primary unilateral total hip replacement admitted between January 2019 and January 2021 were recruited. The patients were divided into three groups (42 people in each group) by random number table method. In group I, 2.0 g TXA was perfused locally into the hip joint cavity through the drainage tube for 2 h. Group II was perfused locally with the same method for 4 h. Group III was given TXA 15 mg/kg intravenously 5–10 min before surgical incision. The hemoglobin concentration, red blood cell (RBC) count, international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-Dimer (D-D), intraoperative blood loss, postoperative blood loss, implicit blood loss, total blood loss, postoperative blood transfusion and complications were compared. Results: The postoperative drainage volume of group I (195.07 ± 34.65) mL and group II (199.62 ± 38.07) mL was significantly lower than that of group III (213.12 ± 25.05) mL (P = 0.037). There was no significant difference in postoperative drainage between group I and group II (P > 0.05). There was no significant difference in intraoperative blood loss, hidden blood loss and total blood loss between the three groups (P > 0.05). There was no difference in the incidence of deep vein thrombosis among the three groups (P > 0.05). Conclusions: TXA is a safe and effective way of hemostasis in total hip arthroplasty. Local intraarticular application of TXA can reduce the postoperative drainage, but the difference is not clinically significant, probably due to the number of samples. There is no difference in the postoperative drainage after local application of 2 or 4 h, and there is no difference in the overall hemostasis effect between intravenous or local application of TXA. [ABSTRACT FROM AUTHOR]

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic infectious disease caused by the severe fever with thrombocytopenia syndrome virus (SFTSV). Endemic in East Asia, SFTS is characterized by an exceptionally high mortality rate. Presently, there is no established treatment for SFTS, particularly for patients in critical condition. In this study, we collected and analyzed laboratory and clinical data from 92 critically ill patients with SFTS treated at Weihai Municipal Hospital between 2019 and 2022. We hope that our study will provide some hints for the treatment of critically ill patients with SFTS. Methods: A total of 92 critically ill patients with SFTS were included in this study. Of these patients, 45 received treatment with therapeutic plasma exchange (TPE) and ribavirin (referred to as the TPE group), while the remaining patients received only ribavirin (referred to as the non‐TPE group). Clinical and laboratory parameters were analyzed retrospectively. Results: The results showed significant improvements in multiple laboratory parameters following treatment with TPE and ribavirin, including white blood cell and neutrophil count, lactate dehydrogenase, creatine kinase isoenzyme‐MB, prothrombin time, activated partial thromboplastin time, D‐Dimer, serum sodium and copies of virus genomes. The combination of TPE with ribavirin demonstrated a significant reduction in mortality rates, with a mortality rate of 20.0% in the TPE group compared to 40.4% in the non‐TPE group (P = 0.033). Conclusions: Our findings suggest that critically ill patients with SFTS who received TPE and ribavirin experienced improvements in both clinical and laboratory parameters. These results indicate that TPE combined with ribavirin may represent a promising novel therapeutic approach for managing critically ill patients with SFTS. However, comparative studies of large sample size or randomized clinical trials are warranted to confirm the effectiveness of this combination therapy in the treatment of severe SFTS cases. [ABSTRACT FROM AUTHOR]

An imbalance in coagulation is associated with cardiovascular events. For prevention and treatment, anticoagulants, currently mainly xabans and gatrans, are used. The purpose of the present study was to provide a head-to-head comparison since there are no studies directly evaluating these novel anticoagulants. An additional aim was to find whether selected anthropological and biochemical factors can affect their anticoagulant properties as they are used in fixed doses. In this cross-sectional study, blood from 50 generally healthy donors was collected, and coagulation responses to dabigatran, argatroban, rivaroxaban, and apixaban, at a concentration of 1 μM, were analyzed. Heparin was used as a positive control. Prothrombin time (PT) expressed as international normalized ratio (INR) and activated partial thromboplastin time (aPTT) were measured and compared. Rivaroxaban was the most active according to PT/INR while argatroban according to aPTT. The ex vivo anticoagulant effect measured by INR correlated inversely with body mass index (BMI) in all four anticoagulants tested. Shortening of aPTT was associated with higher cholesterol and triglyceride levels. No sex-related differences were observed in response to the anticoagulant treatments. As this was an ex vivo study and pharmacokinetic factors were not included, the influence of BMI is of high therapeutic importance. [ABSTRACT FROM AUTHOR]

Background and Aim: The effects of different doses of garlic supplementation on coagulation times after an acute endurance exercise are likely to be varied. The aim of this study was to investigate the effects of different doses of garlic supplementation on partial thromboplastin time (aPTT) and prothrombin time (PT) after an acute endurance exercise in young athletic men. Materials and Methods: Fifteen healthy young active men in the competition stage (age 27.0±7.9 years; weight 73.9±6.4 kg; and VO2max 49.59±0.35 ml/kg/min) with at least three years of experience of regular exercise in 5000 m endurance running voluntarily participated in this study. The subjects took different doses of garlic (500,750 and 1000 mg) and starch (placebo) in four separate sessions. In each session, four hours after taking the supplement or placebo, the subjects performed 30 min of running on treadmill at the intensity of 65-85% of target heart rate. Three blood samples were taken before supplementation, before exercise and immediately after exercise. The repeated measures ANOVA and Bonferroni tests were used to analyze the difference between different doses of garlic after acute endurance exercise and the difference between each doses of garlic and placebo at p<0.05. Results: Three dosage of 500, 750 and 1000 mg garlic were significantly increased aPTT. However, after acute endurance exercise, the three dosages of garlic significantly decreased aPTT. Additionally, the aPTT was significantly more decreased with 500 mg compared to 1000 mg of garlic after acute endurance exercise. There were no significant difference in PT after acute endurance exercise between three different dosage of garlic. Conclusion: It seems that after an acute endurance exercise in active men, 500 mg of garlic is more effective dose for reducing aPTT. [ABSTRACT FROM AUTHOR]

In addition to its undeniable importance for hemostasis, FG is directly related to several physiological and pathophysiological conditions, such as infection, wound healing, tumorigenesis, and the severity of atherosclerosis. It also has a decisive role in the development of pregnancy. Maternal FG is necessary for the progress of pregnancy, as it stabilizes the utero-placental connection at the fibrinoid layer of the fetal-maternal junction. No reports on the study of pathological forms of FG in Ukraine were found. The objective: to compare the indicators of FG concentration and related elements of the blood coagulation system of pregnant and parturient women in different gestational periods and after childbirth. Materials and methods. Blood components from the ulnar vein of 30 women in labor at a gestation period of 22–27 weeks (extremely preterm birth (EPB) – I group), 37 women in labor at a term of 28–34 weeks (early preterm birth (PB) – II group) and 40 women with gestational period 37–41 weeks (control group (CG) – III group) was studied. In the collected samples the content of FG, D-dimer (Dd), prothrombin index (PI), activated partial thromboplastin time (APTT), as well as the levels of hemoglobin (Hb), hematocrit (Ht) and total protein (TP) of the blood plasma were determined. All women in labor were hospitalized in the active phase of the I labor period and did not receive infusion therapy. In terms of gestation, corresponding to EPB, early PB and CG, 10 pregnant women who were on outpatient registration at the Perinatal Center were examined for comparison of the studied indicators outside of labor. Indicators of the biochemical coagulogram were studied on a Helena C-2 semi-automatic coagulometer (Helena Biosciences, Great Britain). Results. The FG concentration increased from 4.2±0.56 g/l in the term 22–27 weeks to 4.4±0.57 g/l before delivery with a diapason of 3.5 to 5.0 g/l. In all parturients, the FG concentration was lower than 4.5 g/l, respectively by group: 4.5±0.81; 4.1±0.74 and 4.1±0.65 g/l (р<0.05). In 24 hours after delivery the FG concentration increased in CG to 5.0±0.82 g/l, and after 48 hours – to 5.3±1.19 g/l, which exceeded the indicators of parturients of the EPB and early PB groups and pregnant women of these same terms, in which the highest indicator was 4.5±0.81 g/l in the EPB group (p<0.05). An increase in the Dd index with growing gestational age was observed in all pregnant women (from 274±133.3 to 501±174.7 μg/l). It continued during the first postpartum day – up to 685±157.5 μg/l, decreased on the second day – 429±198.9 μg/l (p<0.05), approaching the indicators of the EPB and early PB groups (487±267.0 and 397±202.3 μg/l; p>0.05) and pregnant women of the same term. Hb decreased to 106±8.9 g/l, and Ht – to 35±6.1% with the progression of pregnancy. In parturients of the PB group, they were probably higher than the indicators of pregnant women of the corresponding terms, increasing on the second day after delivery – 110±6.7 g/l and 41±3.1%. There was no significant blood loss in the clinical groups. In all pregnant and parturient women the APTT and PI indicators varied from 27.0±3.51 s to 35.4±3.43 s and from 88±4.8% to 101±5.2%, respectively. Conclusions. 1. A gradual increase in the fibrinogen (FG) concentration with increasing gestational age from 4.2±0.56 g/l in 22–27 weeks to 4.4±0.57 g/l by the time of delivery indicates an increase in the level of FG in healthy pregnant women as an adaptive response of the body to the formation of an additional vascular system. 2. An excessive FG increase is a consequence of hemoconcentration, not absolute hyperfibrinogenemia, and may be a sign of pathological processes underlying hypovolemia. In case of extremely preterm birth (EPB), the concentration of FG in the parturient was 4.5±0.81 g/l. Higher values of FG, hemoglobin, and hematocrit in parturients with EPB than in pregnant women at the same term are evidence of insufficient hemodilution, which can be considered as one of the pathogenetic mechanisms of premature labor. 3. Laboratory indicators of the blood coagulation system – APTT, PI – in the absence of bleeding have no diagnostic value. [ABSTRACT FROM AUTHOR]

This article presents the biochemical properties of poly(lactide)-zinc (PLA-Zn) composites obtained by DC magnetron sputtering of zinc onto melt-blown nonwoven fabrics. The biochemical properties were determined by the evaluation of the activated partial thromboplastin time (aPTT) and prothrombin time (PT). The antimicrobial activity of the PLA-Zn samples was additionally tested against representative Gram-positive and Gram-negative bacteria strains. A structural study of the PLA-Zn has been carried out using specific surface area and total pore volume (BET) analysis, as well as atomic absorption spectrometry with flame excitation (FAAS). PLA-Zn composites exhibited an antibacterial effect against the analyzed strains and produced inhibition zones against E. coli and S. aureus. Biochemical investigations revealed that the untreated PLA fibers caused the acceleration of the clotting of human blood plasma in the intrinsic pathway. However, the PLA-Zn composites demonstrated significantly different properties in this regard, the aPTT was prolonged while the PT was not altered. [ABSTRACT FROM AUTHOR]

Background: Tests for hemostasis include prothrombin time (PT) and activated thromboplastin time (aPTT). Prothrombin time (PT) and activated partial thromboplastin time (APTT) are tests of hemostasis employed in the evaluation of coagulopathies and monitoring of anticoagulant drug therapy. These tests are supposed to be influences by many preanalytical factors. Objective: In this study, we have evaluated the stability of aliquoted plasma of blood sample collected in sodium citrate tubes for prothrombin time and activated partial thromboplastin time stored at -20°C for a period of 7 days. Material and Methods: 67 Patients samples collected for PT and APTT were stored for 7 days at -20°C in different aliquots. One aliquot is taken out daily and tested for PT and aPTT. Results were compared with initial tests results. Results: It was found that there was no significant difference between initial test results and test results of the samples are stored at -20°C. Conclusion: Samples which are collected for coagulation studies in sodium citrate preservative, if are centrifuged immediately and plasma is stored at -20°C, result generated for PT and aPTT do not show any statistically significant difference compared to samples which are immediately processed. [ABSTRACT FROM AUTHOR]

This document presents the findings of a study on risk factors for early death in severe non-brain-injured trauma patients. The study analyzed various indicators, including Glasgow Coma Scale (GCS) score, spinal injury, blood pH, and clotting function, to determine their predictive value for early death. The results showed that lower GCS scores, spinal injury, lower blood pH, and longer activated partial thromboplastin time (APTT) were associated with increased early death. The combination of these indicators had the highest predictive value for early death. However, the study had limitations, such as its retrospective design and small sample size. [Extracted from the article]

This article discusses the effectiveness and safety of upadacitinib, a selective JAK1 inhibitor, for pediatric patients with moderate-to-severe atopic dermatitis (AD) who did not respond to dupilumab treatment. The study included 12 patients aged 6-14 who had failed conventional topical corticosteroid treatment and had a history of poor response to dupilumab. Significant improvements were observed in various clinical endpoints, including Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS), and Children's Dermatology Life Quality Index (CDLQI). Adverse events were generally mild, with acne being the most common. Infections were reported in 25% of patients, highlighting a potential risk for younger patients. One serious adverse event of appendicitis was reported, although a direct causal relationship with upadacitinib remains unclear. Routine laboratory monitoring is important for detecting and managing adverse events. One patient developed vitiligo during treatment, which may be attributed to the common coexistence of AD and vitiligo rather than being an adverse effect of upadacitinib. The study acknowledges limitations such as the small sample size and lack of a control group, emphasizing the need for long-term follow-up to assess the sustained efficacy and safety of upadacitinib in pediatric patients. [Extracted from the article]

Purpose: To predict the post transurethral prostate resection(TURP) urethral stricture probability by applying different machine learning algorithms using the data obtained from preoperative blood parameters. Methods: A retrospective analysis of data from patients who underwent bipolar-TURP encompassing patient characteristics, preoperative routine blood test outcomes, and post-surgery uroflowmetry were used to develop and educate machine learning models. Various metrics, such as F1 score, model accuracy, negative predictive value, positive predictive value, sensitivity, specificity, Youden Index, ROC AUC value, and confidence interval for each model, were used to assess the predictive performance of machine learning models for urethral stricture development. Results: A total of 109 patients' data (55 patients without urethral stricture and 54 patients with urethral stricture) were included in the study after implementing strict inclusion and exclusion criteria. The preoperative Platelet Distribution Width, Mean Platelet Volume, Plateletcrit, Activated Partial Thromboplastin Time, and Prothrombin Time values were statistically meaningful between the two cohorts. After applying the data to the machine learning systems, the accuracy prediction scores for the diverse algorithms were as follows: decision trees (0.82), logistic regression (0.82), random forests (0.91), support vector machines (0.86), K-nearest neighbors (0.82), and naïve Bayes (0.77). Conclusion: Our machine learning models' accuracy in predicting the post-TURP urethral stricture probability has demonstrated significant success. Exploring prospective studies that integrate supplementary variables has the potential to enhance the precision and accuracy of machine learning models, consequently progressing their ability to predict post-TURP urethral stricture risk. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia (PE), an obstetric disorder, remains one of the leading causes of maternal and infant mortality worldwide. In individuals with PE, the coagulation-fibrinolytic system is believed to be among the most significantly impacted systems due to maternal inflammatory responses and immune dysfunction. Therefore, this systematic review and meta-analysis aimed to assess the association of prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) levels with preeclampsia. Methods: This systematic review and meta-analysis was conducted in accordance with the PRISMA guidelines. Articles relevant to the study, published from July 26, 2013, to July 26, 2023, were systematically searched across various databases including PubMed, Scopus, Embase, and Hinari. The methodological quality of the articles was evaluated using the Joanna Briggs Institute critical appraisal checklist. Utilizing Stata version 14.0, a random-effects model was employed to estimate the pooled standardized mean difference (SMD) along with the respective 95% CIs. The I2 statistics and Cochrane Q test were utilized to assess heterogeneity, while subgroup analyses were performed to explore its sources. Furthermore, Egger's regression test and funnel plot were employed to assess publication bias among the included studies. Results: A total of 30 articles, involving 5,964 individuals (2,883 with PE and 3,081 as normotensive pregnant mothers), were included in this study. The overall pooled SMD for PT, APTT, and TT between PE and normotensive pregnant mothers were 0.97 (95% CI: 0.65–1.29, p < 0.001), 1.05 (95% CI: 0.74–1.36, p < 0.001), and 0.30 (95% CI: -0.08-0.69, p = 0.11), respectively. The pooled SMD indicates a significant increase in PT and APTT levels among PE patients compared to normotensive pregnant mothers, while the increase in TT levels among PE patients was not statistically significant. Conclusions: The meta-analysis underscores the association between PE and prolonged PT and APTT. This suggests that evaluating coagulation parameters like PT, APTT, and TT in pregnant women could offer easily accessible and cost-effective clinical indicators for assessing PE. However, multicenter longitudinal studies are needed to evaluate their effectiveness across various gestational weeks of pregnancy. [ABSTRACT FROM AUTHOR]

Background: Heavy menstrual bleeding is an important health problem in women of reproductive age and is also one of the most common symptoms in women with bleeding disorders. Data about the frequency of rare bleeding disorders are limited, and population-based studies are lacking, so we aimed to determine the frequency of rare bleeding disorders among women presented with heavy menstrual periods that cannot be attributed to obvious problems. Methods: Complete blood count and bleeding profiles include activated partial thromboplastin time, prothrombin time, factor VIII activity assay, ristocetin cofactor activity, von Willebrand antigen assay, platelet aggregation tests and other factor assays in 100 out of 300 females presented with unexplained heavy menstrual period, pictorial bleeding assessment chart (PBAC) > 100 as a screening tool for heavy menstrual periods, and or International Society of Thrombosis and Hemostasis-Bleeding Assessment Tool (ISTH-BAT) > 6. Results: A total of 300 women with heavy menstrual periods without an obvious explained cause were included in our study. Among them, we found 100 (30%) females with a mean PBAC of 234 ± 147 and mean ISTH-BAT of 9 ± 5 denoting HMB may be due to underlying bleeding disorders. Among them, the most common diagnosis was VWD in 30 (30%). Other disorders were as follows: 28 (28%) cases with clotting factor deficiencies, 24 (24%) cases were found to have platelet dysfunction, and in 18% of our studied cases, we did not find a clear cause of their bleeding disorders (unknown). Conclusion: Rare bleeding disorders are not uncommon and require comprehensive hemostatic evaluation as well as simple tools like PBAC and ISTH-BAT questionnaires for the identification of females presented with unexplained HMB. [ABSTRACT FROM AUTHOR]

Background: Isolated prolongation of activated partial thromboplastin time (APTT) has various causes including inheritable bleeding disorders, and has medical significance as it can lead to the cancelation of surgery. However, even an emergency surgery can be conducted in a patient presenting with severe APTT prolongation, provided careful evaluation and appropriate measures are taken. Hence, the identification of the underlying etiology of the prolonged APTT is crucial. To date, little evidence exists regarding the prevalence of isolated APTT prolongation in Japanese patients undergoing surgery. Herein, we aimed to clarify the prevalence of isolated prolongation of APTT in the preoperative setting and to identify the reasons underlying isolated, severely prolonged APTT. Methods: Preoperative coagulation data of all elective and emergent patients who presented to the anesthetic department between January 1, 2020, and June 30, 2023, were retrospectively collected. Isolated prolongation of APTT was defined as an APTT ≥ 37 s with an international normalized ratio of prothrombin time < 1.2. The underlying etiology of the patient with isolated, severely prolonged APTT (≥ 46 s) was investigated, and canceled surgical procedures in relation to the isolated APTT prolongation were searched. Results: Overall, 10,684 measurements from 9413 patients were included, of which 725 (6.8%) were identified as having isolated APTT prolongation. The reasons for the severely prolonged APTT (n = 60) were miscellaneous, with the most frequently detected etiology being antiphospholipid antibody positivity. Preoperative isolated APTT prolongation contributed to the cancellation of surgery in elective five cases. Conclusions: We clarified the prevalence of preoperative isolated prolongation of APTT. The presence of antiphospholipid antibody was the most frequently detected etiology of the patient with isolated, severely prolonged APTT. The present study provides an important dataset regarding the isolated prolongation of APTT in East Asian patients undergoing surgery. [ABSTRACT FROM AUTHOR]

This research attempted to explore the effect of induction therapy on changes in nutritional status and chemotherapy complications in children with acute lymphoblastic leukemia. One hundred newly diagnosed patients were randomly assigned to observation and control groups, each comprising 50 participants. Both groups received chemotherapy; however, their dietary regimen differed. The control group received a conventional low-fat diet, while the observation group received onefourth to one-third of daily total energy intake through enteral nutrition preparations and the remaining energy intake through a conventional low-fat diet until the end of the induction remission period. This study revealed no significant differences between the two groups regarding mid-arm circumference, skinfold thickness, body mass index, and serum albumin levels before and after therapy. After therapy, total protein and prealbumin levels were significantly higher in the observation group compared to the control group. Moreover, the incidence of neutropenia and anemia, average numbers of transfusions of red blood cells and platelets, alanine aminotransferase, activated partial thromboplastin time prolongation, and the incidence of fever were not significantly different between the two groups after therapy. In conclusion, enteral nutrition support elevated selected biochemical markers, but it did not substantially alter nutritional biomarkers and hematological and non-hematological complications. [ABSTRACT FROM AUTHOR]

In patients with unremarkable medical history, comprehensive preoperative hemostasis screening in elective neurosurgery remains debated. Comprehensive medical history has shown to be noninferior to coagulation profile to evaluate surgical outcomes. This study aims to evaluate the predictiveness of preoperative coagulation screening and medical history for surgical outcomes. Databases were searched until April 2023 for observational cohort studies that reported preoperative hemostasis screening and clinical history prior to elective neurosurgical procedures. Outcomes of interest included postoperative transfusion, mortality, and complications. Pooled relative risk ratios (RRs) were analyzed using random-effects models. Out of 604 studies, 3 cohort studies met our inclusion criteria, adding a patient population of 83,076. Prolonged partial thromboplastin time (PTT; RR=1.42, 95% confidence interval [CI] =1.14, 1.77, P =0.002), elevated international normalized ratio (INR; RR=2.01, 95% CI=1.14, 3.55, P =0.02), low platelet count (RR=1.58, 95% CI=1.34, 1.86, P <0.00001), and positive bleeding history (RR=2.14, 95% CI=1.16, 3.93, P =0.01) were associated with postoperative transfusion risk. High PTT (RR=2.42, 95% CI=1.24, 4.73, P =0.010), High INR (RR=8.15, 95% CI=5.97, 11.13; P <0.00001), low platelet count (RR=4.89, 95% CI=3.73, 6.41, P <0.00001), and bleeding history (RR=7.59, 95% CI=5.84, 9.86, P <0.00001) were predictive of mortality. Prolonged PTT (RR=1.53, 95% CI=1.25, 1.86, P =<0.0001), a high INR (RR=3.41, 95% CI=2.63, 4.42, P =< 0.00001), low platelets (RR=1.63, 95% CI=1.40, 1.90, P =<0.00001), and medical history (RR=2.15, 95% CI=1.71, 2.71, P =<0.00001) were predictive of complications. Medical history was a noninferior predictor to coagulation profile for postoperative transfusion, mortality, and complications. However, our findings are mostly representative of elective spinal procedures. Cost-effective alternatives should be explored to promote affordable patient care in patients with unremarkable history. [ABSTRACT FROM AUTHOR]

Summary: Prolonged coagulation times, such as activated partial thromboplastin time (APTT) and thrombin time (TT), are common in patients infected with severe fever with thrombocytopenia syndrome virus (SFTSV) and have been confirmed to be related to patient's poor outcome by previous studies. To find out the reason for prolonged coagulation time in patients with SFTSV infection, and whether it predicts haemorrhagic risk or not. Seventy‐eight consecutive patients with confirmed SFTSV infection were enrolled in this prospective, single‐centre, observational study. Several global and specific coagulation parameters of these patients on admission were detected, and the haemorrhagic events during hospitalization and their outcomes were recorded. Most of the enrolled patients had prolonged APTT (82.1%) and TT (80.8%), normal prothrombin time (83.3%) and intrinsic coagulation factors above haemostatic levels (97.4%). The heparin‐like effect was confirmed by a protamine neutralization test and anti‐Xa activity detection in most patients. Interestingly, the APTT and TT results were significantly positively correlated with the levels of endothelial markers and viral load, respectively. The APTT was independently associated with the haemorrhage of patients. The prolonged APTT and TT of SFTS patients may mainly be attributed to endogenous heparinoids and are associated with increased haemorrhagic risk. [ABSTRACT FROM AUTHOR]

Objective: To explore influencing factors of poor prognosis in patients with severe trauma, and to analyze distribution characteristics of adverse prognostic factors in patients with different early peripheral blood lymphocyte levels based on potential categories. Methods: A total of 174 patients with severe trauma treated in Mianyang Central Hospital from September 2020 to September 2022 were selected. According to condition of massive blood transfusion or death within 24 hours after admission, patients were divided into: good prognosis group (n=136) and poor prognosis group (n=38). Clinical data of two groups were compared, multivariate Logistic regression analysis was used to analyze factors affecting poor prognosis, and cluster analysis and potential classification were used to analyze distribution characteristics of adverse prognostic factors in patients with different early peripheral blood lymphocyte levels. Results: Multivariate Logistic regression analysis results showed decrease of Glasgow coma scale (GCS), prolongation of activated partial thromboplastin time (APTT), increase of D-dimer (D-D), decrease of fibrinogen (Fib), increase of fibrinogen degradation products (FDP), increase of neutrophil/lymphocyte ratio (NLR) and decrease of lymphocyte level were factors influencing poor prognosis (P<0.05). Cluster analysis results showed that risk of poor prognosis was obviously clustered, and patients could be divided into poor prognosis high risk group (lymphocyte level≤0.90x109 L-1, n=72) and low risk group (lymphocyte level>0.90x109 L-1, n=102). Incidence of poor prognosis in high risk group [33.33%(24/72) ] was significantly higher than that in low risk group [13.73% (14/102)] (P<0.05). Potential category analysis results showed that there were three potential category distribution patterns in poor prognosis high risk group and low risk group. Proportion of "unelevated distribution of D-D in patients with low GCS score" in high risk group was significantly higher than that in low risk group, and proportion of "distribution of less risk factors" in high risk group was significantly lower than that in low risk group (P<0.05). There was no significant difference in proportion of elevated D-D distribution in patients with low GCS score between two groups (P>0.05). Conclusion:Decrease of GCS score, prolongation of APTT and increase of D-D are all associated with poor prognosis in patients with severe trauma. Patients with lymphocyte level ≤0.90x109 L-1 have a higher risk of poor prognosis, and main influencing factors are "non-elevated distribution of D-D in patients with low GCS score". [ABSTRACT FROM AUTHOR]

Purpose: Percutaneous endoscopic transforaminal lumbar interbody fusion (PE-TLIF) has become one of the most popular minimally invasive surgeries today. However, the issue of hidden blood loss (HBL) in this surgery has received little attention. This study aims to examine the HBL in PE-TLIF surgery and the effect of tranexamic acid (TXA) on blood loss. Methods: In our research, We conducted a retrospective analysis of 300 patients who underwent PE-TLIF from September 2019 to August 2023. They were divided into 2 groups based on whether they received intravenous TXA injection before surgery. The variables compared included: demographic data, pre-and postoperative hemoglobin (HB), hematocrit (HCT), platelets (PLT), red blood cells (RBC), total blood loss (TBL), visible blood loss (VBL), HBL, operation time, postoperative hospital stay, inflammatory markers, coagulation parameters, and adverse events. Results: Regarding demographic characteristics, besides the operation time, no significant differences were observed between the two groups. Compared with the control group, the TXA group showed a significant reduction trend in TBL, HBL, and VBL (P < 0.05). On the first day after surgery, there were significant differences in prothrombin (PT), activated partial thromboplastin time (APTT), and D-dimer (D-D) levels between the two groups. Similarly, HCT also found similar results on the third day after surgery. No adverse events occurred in either group. Conclusion: Research has found that there is a significant amount of HBL in patients undergoing PE-TLIF. Intravenous injection of TXA can safely and effectively reduce perioperative HBL and VBL. Additionally, compared to the control group, the TXA group shows a significant reduction in operation time. [ABSTRACT FROM AUTHOR]

During inflammation and situations of cellular stress protein disulfide isomerase (PDI) is released in the blood plasma from the platelet and endothelial cells to influence thrombosis. The addition of exogenous PDI makes the environment pro-thrombotic by inducing disulfide bond formation in specific plasma protein targets like vitronectin, factor V, and factor XI. However, the mechanistic details of PDI interaction with its target remain largely unknown. A decrease in the coagulation time was detected in activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) on addition of the purified recombinant PDI (175 nM). The coagulation time can be controlled using an activator (quercetin penta sulfate, QPS) or an inhibitor (quercetin 3-rutinoside, Q3R) of PDI activity. Likewise, the PDI variants that increase the PDI activity (H399R) decrease, and the variant with low activity (C53A) increases the blood coagulation time. An SDS-PAGE and Western blot analysis showed that the PDI does not form a stable complex with either thrombin or antithrombin (ATIII) but it uses the ATIII-thrombin complex as a template to bind and maintain its activity. A complete inhibition of thrombin activity on the formation of ATIII-thrombin-PDI complex, and the complex-bound PDI-catalyzed disulfide bond formation of the target proteins may control the pro- and anti-thrombotic role of PDI. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus 2019 symptoms include coagulopathy and thromboembolic risk. Using one parameter to diagnose coagulopathy has little predictive value. Objective: This study will examine if D-dimer and APTT testing can predict COVID-19 severity and aid triage and manage patients. Methods: 214 COVID-19 patients were enrolled and classified into two categories based on their respiratory manifestations; mild (126 cases) and severe (88 cases). Patient data regarding age, gender, D-Dimer level, and APTT level were collected. When both D-Dimer and APTT levels were abnormal, in this study, the patient was considered to have a coagulation disorder. Indicators of coagulation in the COVID-19 patients were collected and compared between the two groups. Chi-square (Χ2) tests were used to determine the significant differences between coagulation disorders in the two groups. Results: Our findings showed that patients with coagulopathies were more likely to belong to the severe group. Within the two groups of patients, the rate of coagulation disorders was as follows: mild = 8.8 % within coagulation disorders, 4.8% within the two Groups; severe = 91.2 % within coagulation disorders, 77.8 % within the two Groups. There was a statistically significant relationship between coagulation disorder and severe COVID-19 patients compared to mild patients (p < 0.05). Conclusions: Coagulation disorders are more likely to occur in severe COVID-19 patients. D-Dimer and APTT tests are significant indicators for predicting COVID-19 severity. Our research found an abnormal pattern of coagulation disorders and COVID-19 severity that should be considered in the COVID-19 treatment protocol. [ABSTRACT FROM AUTHOR]

This current article was dedicated to the determination of the composition of phenolic compounds in extracts of four species of the genus Filipendula in order to establish a connection between the composition of polyphenols and biological effects. A chemical analysis revealed that the composition of the extracts studied depended both on the plant species and its part (leaf or flower) and on the extractant used. All four species of Filipendula were rich sources of phenolic compounds and contained hydrolyzable tannins, condensed tannins, phenolic acids and their derivatives, and flavonoids. The activities included data on those that are most important for creating functional foods with Filipendula plant components: the influence on blood coagulation measured by prothrombin and activated partial thromboplastin time, and on the activity of the digestive enzymes (pancreatic amylase and lipase). It was established that plant species, their parts, and extraction methods contribute meaningfully to biological activity. The most prominent result is as follows: the plant organ determines the selective inhibition of either amylase or lipase; thus, the anticoagulant activities of F. camtschatica and F. stepposa hold promise for health-promoting food formulations associated with general metabolic disorders. [ABSTRACT FROM AUTHOR]

Objective: This work measures the intra‐operative bleeding in end‐stage renal disease patients and assesses whether laboratory coagulation tests and nitrogenous compounds are related to a higher bleeding risk. Methods: Laboratory tests were performed on the day of surgery and some patients with thrombocytopenia and values above the normal levels of international normalised ratio (INR), thrombin time (TT) and activated partial thromboplastin time (aPTT) were identified. Results: Haemostatic time ranged from 2 to 35 min (mean of 8.51 min) after suture. Bleeding volume ranged from 0.02 to 67.06 mL (mean of 4.38 mL) and the bleeding volume per minute ranged from 0.05 to 2.10 mL/min (median of 0.6 mL/min). Only seven patients (16.27%) had abnormal bleeding (more than 0.6 mL/min). Spearman's coefficient showed weak correlations between bleeding volume (mL/min) and serum urea (r = 0.226), TT (r = 0.227), plasma urea (r = 0.148) and creatinine (r = 146), as well as very weak correlations with all other variables (r < 0.140) such as age, haemodialysis time, glycaemia, glycated haemoglobin, platelets, INR, aPTT and fibrinogen. Conclusion: It was not possible to associate any laboratory test or nitrogenous compounds present in the blood and saliva with an increased bleeding. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the effects of lipemia on clinical chemistry and coagulation parameters in native ultralipemic (NULM) and intravenous lipid emulsion (IVLE) spiked samples. Materials and methods: The evaluation of biochemistry (photometric, ion-selective electrode, immunoturbidimetric method), cardiac (electrochemiluminescence immunoassay method) and coagulation (the viscosity-based mechanical method for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and the immunoturbidimetric method for D-dimer) parameters were conducted. In addition to the main pools, five pools were prepared for both types of lipemia, each with triglyceride (TG) concentrations of approximately 2.8, 5.7, 11.3, 17.0 and 22.6 mmol/L. All parameters' mean differences (MD%) were presented as interferographs and compared with the desirable specification for the inaccuracy (bias%). Data were also evaluated by repeated measures of ANOVA. Results: Prothrombin time and APTT showed no clinically relevant interference in IVLE-added pools but were negatively affected in NULM pools (P < 0.001 in both parameters). For biochemistry, the most striking difference was seen for CRP; it is up to 134 MD% value with NULM (P < 0.001) at the highest TG concentration, whereas it was up to - 2.49 MD% value with IVLE (P = 0.009). Albumin was affected negatively upward of 5.7 mmol/L TG with IVLE, while there was no effect for NULM. Creatinine displayed significant positive interferences with NULM starting at the lowest TG concentration (P = 0.028). There was no clinically relevant interference in cardiac markers for both lipemia types. Conclusions: Significant differences were scrutinized in interference patterns of lipemia types, emphasizing the need for careful consideration of lipemia interferences in clinical laboratories. It is crucial to note that lipid emulsions inadequately replicate lipemic samples. [ABSTRACT FROM AUTHOR]

Antiphospholipid syndrome (APS) is a rare systemic autoimmune disease characterized by recurrent pregnancy morbidity or thrombosis in combination with the persistent presence of antiphospholipid antibodies (aPLs) in plasma/serum. Antiphospholipid antibodies are a heterogeneous, overlapping group of autoantibodies, of which anti-β2-glycoprotein I (aβ2GPI), anticardiolipin (aCL) antibodies and antibodies that prolong plasma clotting time in tests in vitro known as lupus anticoagulant (LAC) are included in the laboratory criteria for the diagnosis of APS. The presence of LAC antibodies in plasma is indirectly determined by measuring the length of coagulation in two tests - activated partial thromboplastin time (aPTT) and diluted Russell's viper venom time (dRVVT). The concentration of aβ2GPI and aCL (immunglobulin G (IgG) and immunoglobulin M (IgM) isotypes) in serum is directly determined by solid-phase immunoassays, either by enzyme-linked immunosorbent assay (ELISA), fluoroimmunoassay (FIA), immunochemiluminescence (CLIA) or multiplex flow immunoassay (MFIA). For patient safety, it is extremely important to control all three phases of laboratory testing, i.e. preanalytical, analytical and postanalytical phase. Specialists in laboratory medicine must be aware of interferences in all three phases of laboratory testing, in order to minimize these interferences. The aim of this review was to show the current pathophysiological aspects of APS, the importance of determining aPLs-a in plasma/serum, with an emphasis on possible interferences that should be taken into account when interpreting laboratory findings. [ABSTRACT FROM AUTHOR]

Objectives: In our center, an unusual rate of patients had abnormalities of hemostasis in immediate postoperative period of cardiac surgery. Our objectives were to identify the cause of these sudden hemostasis abnormalities and to evaluate the performances of point of care coagulation testing. Methods: In this prospective and descriptive study, we included 33 consecutive patients undergoing elective cardiac surgery for 1 month. Heparin-induced anticoagulation and calculation of the protamine dose were tested by the Hemostasis Management System Plus device (Medtronic, Minneapolis, MN, USA). Fifteen minutes after the end of the protamine infusion, activated clotting time (ACT), activated partial thromboplastin time and anti Xa activity were measured. In case of unusual clinical bleeding, a Quantra analysis (Stago, HemoSonics LLC, Charlottesville, VA) was added. Results: Residual antiXa activity >0.2 IU/mL after neutralization was present in 44% of patients. Our investigation concluded incomplete heparin reversal. There was no association between cellular reinfusate and the presence of heparin. The unusual rate of hemostasis abnormalities was explained by a less efficient protamine reversal of heparin. ACT and Clot Time Ratio (CTR, Quantra system) correlated with AntiXa with Spearman's coefficients of 0.85 (p <.0001) and 0.95 (p =.0012), respectively. About ACT, a threshold of 150 seconds had a sensitivity of 85% [58–97] and a specificity of 85% [58–97%] for detection of AntiXa>0.2. For CTR, a threshold of 1.4 had a sensitivity of 67% [30–94] and a specificity of 100% [18–100]. Conclusion: The use of point of care coagulation testing is effective in detecting incomplete reversal of heparin. [ABSTRACT FROM AUTHOR]

This study aims to assess the differences in coagulation function, intraoperative bleeding and hemostasis time resulting from immediate versus delayed infusion of residual physical blood in patients undergoing cardiopulmonary bypass for aortic dissection. From January 2018 to January 2021, the data of 122 patients diagnosed with acute Stanford type A aortic dissection and treated at Taihe Hospital Affiliated Hospital of Hubei University of Medicine were retrieved and assessed. They were then divided into two groups according to different treatments: a research group and a control group. The research group received a delayed infusion of residual physical blood intraoperatively, while the control group underwent immediate infusion. Various indicators of coagulation, encompassing activated partial thromboplastin time, prothrombin time, thrombin time, and fibrinogen levels, along with hemoglobin levels, utilization of blood products such as red cell suspension, plasma, platelets, and cryoprecipitate, as well as the volume of bleeding, total fluid intake and output, and durations of hemostasis, surgery, and anesthesia, were compared between the two groups. After surgery, coagulation and hemoglobin levels, which were initially similar between the two groups, were found to be significantly improved, with the research group showing superior outcomes (p < 0.05). Additionally, patients in the research group required significantly fewer blood products, experienced reduced bleeding and total body fluid exchange and had markedly shorter durations of hemostasis, surgery and anesthesia compared to those in the control group (p < 0.05). Pre-infusion adjustment of coagulation function before residual whole blood infusion effectively improves coagulation, reduces bleeding and fluid imbalance, and shortens hemostasis time during aortic dissection surgery with cardiopulmonary bypass. This approach not only reduces transfusion-related risks and improves postoperative recovery but also plays a significant role in optimizing blood management. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stroke is the second reason for global deaths and a major reason for disabilities. OBJECTIVE: To unravel the clinical value of the coagulation index and serum inflammatory cytokines in hemorrhagic stroke patients with pulmonary infection in the sequelae stage. METHODS: Altogether, 130 hemorrhagic stroke patients who received treatment in Hebei General Hospital from April 2019 to December 2020 were selected. Patients were classified into the infection group (n = 65) and non-infection group (n = 65) according to whether they had a pulmonary infection in the sequelae stage of hemorrhagic stroke. Levels of coagulation index and serum inflammatory cytokines of patients in two groups were compared. Multiple linear regression analysis was used to analyze pulmonary infection-related factors of hemorrhagic stroke patients. The diagnostic value of the coagulation index and serum inflammatory cytokines in pulmonary infection was analyzed by the receiver operating characteristic (ROC) curve. RESULTS: Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D), platelet (PLT) related to coagulation function levels and interleukin 1 β (IL-1 β), interleukin 17 (IL-17) related to serum inflammatory cytokines levels of patients in the infection group were higher than those in non-infection groups (p < 0.05). Multiple linear regression analysis uncovered that FIB, D-D, PLT, and IL-17 were influencing factors of pulmonary infection in the sequelae of patients with hemorrhagic stroke (p < 0.05). Area under the curve (AUC) values of pulmonary infection in the sequelae stage of patients with hemorrhagic stroke diagnosed by FIB, D-D, PLT, and IL-17 were 0.823, 0.758, 0.660, and 0.755, respectively. CONCLUSION: FIB, D-D, PLT, and IL-17 levels could be used for pulmonary infection diagnosis in the sequelae stage of hemorrhagic stroke patients. [ABSTRACT FROM AUTHOR]

Invasive pulmonary aspergillosis (IPA) is a life‐threatening complication in patients with severe fever with thrombocytopenia syndrome (SFTS), yet SFTS‐associated IPA (SAPA)'s risk factors remain undefined. A multicenter retrospective cohort study across Hubei and Anhui provinces (May 2013–September 2022) utilized least absolute shrinkage and selection operator (LASSO) regression for variable selection. Multivariable logistic regression identified independent predictors of SAPA, Cox regression highlighted mortality‐related risk factors. Of the 1775 screened SFTS patients, 1650 were included, with 169 developing IPA, leading to a 42‐day mortality rate of 26.6% among SAPA patients. Multivariable logistic regression revealed SAPA risk factors including advanced age, petechia, hemoptysis, tremor, low albumin levels, elongated activated partial thromboplastin time (APTT), intensive care unit (ICU) admission, glucocorticoid usage, intravenous immunoglobulin (IVIG) and prolonged hospital stays. Cox regression identified predictors of 42‐day mortality, including ecchymosis at venipuncture sites, absence of ICU admission, elongated prothrombin time (PT), vasopressor and glucocorticoid use, non‐antifungals. Nomograms constructed on these predictors registered concordance indexes of 0.855 (95% CI: 0.826–0.884) and 0.778 (95% CI: 0.702–0.854) for SAPA onset and 42‐day mortality, respectively. Lower survival rates for SAPA patients treated with glucocorticoids (p < 0.001) and improved 14‐day survival with antifungal therapy (p = 0.036). Improving IPA management in SFTS‐endemic areas is crucial, with effective predictive tool. [ABSTRACT FROM AUTHOR]

Introduction. The aim of this study was to determine the serum biochemical markers that can predict the risk of haemorrhagic transformation (HT) before and after endovascular treatment (EVT). Material and methods. This study included patients with anterior circulation large vessel occlusion (ACLVO) who underwent EVT within six hours of symptom onset between September 2017 and September 2022. These patients were retrospectively categorised into two groups: an HT group and a No-HT group. Results. A total of 180 patients were included in the study, of whom 55 (30.6%) had HT. The monocyte count before EVT (p = = 0.005, OR = 0.694, 95% CI 0.536-0.898), the activated partial thromboplastin time before EVT (p = 0.009, OR = 0.186, 95% CI 0.699-0.952), and the eosinophil count after EVT (p = 0.038, OR = 0.001, 95% CI 0.000-0.018) were all found to be independent predictors of HT, with warning values of 6.65%, 22.95 seconds, and 0.035*10^9/L, respectively. When compared to prediction using only demographic data [AUC = 0.662,95% CI (0.545, 0.780)], adding biochemical indices before EVT [AUC = 0.719,95% CI (0.617, 0.821)], adding biochemical indices after EVT [AUC = 0.670,95% CI (0.566, 0.773)], and adding both [AUC = 0.778,95% CI (0.686, 0.870)], the prediction efficiency of HT was improved among all three combinations, with no statistical significance. Conclusions. The levels of serum biochemical markers were found to show significant changes before and after EVT in ACLVO patients. A combination of demographic data and serum biochemical markers proved to be effective in predicting the occurrence of HT in patients with ACLVO who underwent EVT. [ABSTRACT FROM AUTHOR]

Background & Objective: Uncertainties exist about the diagnostic and prognostic role of hemocytometry values in patients with COVID-19 especially in pregnancy. This study aims to investigate hemostatic changes in pregnant woman with coronavirus disease (COVID-19) and their relationship to disease severity. Materials & Methods: This research is an analytic observational study with case control design. Subject was gathered from Hasan Sadikin General Hospital Bandung, Indonesia patients' medical records from June 2021 - March 2022. Inclusion criteria for this study are all pregnant COVID-19 patients with prothrombin time (PT), activated partial thromboplastin time (aPTT), and D-dimer examination. The exclusion of this study, all pregnant COVID-19 patients without required examination. PT, aPTT, and D-dimer were measured by Stago kits on a Stago automated coagulation analyzer (STA Compact Max®). Data was then analyzed by Kruskal Wallis with IBM SPSS Statistic 26th with α=0.05. Results: Statistical analysis shows there's correlation between different severity levels with D-Dimer. This study shows the mean of D-Dimer of each severity levels; asymptomatic 4.85 mg/L, mild 2.86 mg/L, moderate 5.47 mg/L and severe 14.51 mg/L (p <0.000). Changes seen after mild group which increase to 5.47 mg/dL in moderate COVID-19 and furthermore increase in severe become 14.51 mg/L. No changes in PT and aPTT were found. Conclusion: In conclusion, our findings demonstrate that coagulopathy is associated with the severity of COVID-19 illness. D-dimer is an important parameter for evaluating the COVID-19 severity in pregnancy. This further could serve as a diagnostic category to differ the severity of COVID-19 in pregnancy. [ABSTRACT FROM AUTHOR]

A novel fibrinolytic enzyme was produced by the liquid fermentation of Coprinus comatus. The enzyme was purified from the culture supernatant by hydrophobic interactions, gel filtration, and ion exchange chromatographies. It was purified by 241.02-fold, with a specific activity of 3619 U/mg and a final yield of 10.02%. SDS-PAGE analysis confirmed the purity of the enzyme, showing a single band with a molecular weight of 19.5 kDa. The first nine amino acids of the N-terminal of the purified enzyme were A-T-Y-T-G-G-S-Q-T. The enzyme exhibited optimal activity at a temperature of 42 °C and pH 7.6. Its activity was significantly improved by Zn2+, K+, Ca2+, Mn2+, and Mg2+ while being inhibited by Fe2+, Fe3+, Al2+, and Ba2+. The activity of the enzyme was completely inhibited by ethylenediamine tetraacetic acid (EDTA), and it was also dose-dependently inhibited by phenylmethylsulfonyl fluoride (PMSF) and soy trypsin inhibitor (SBTI). However, inhibitors such as N-α-tosyl-L-phenylalanine chloromethyl ketone (TPCK), aprotinin, and pepstatin did not significantly affect its activity, suggesting that the enzyme was a serine-like metalloproteinase. The enzyme acted as both a plasmin-like fibrinolytic enzyme and a plasminogen activator, and it also exhibited the capability to hydrolyze fibrinogen and fibrin. In vitro, it demonstrated the ability to dissolve blood clots and exhibit anticoagulant properties. Furthermore, it was found that the enzyme prolonged activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT), and reduced the levels of fibrinogen (FIB) and prothrombin activity (PA). Based on these studies, the enzyme has great potential to be developed as a natural agent for the prevention and treatment of thrombotic diseases. [ABSTRACT FROM AUTHOR]

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To evaluate the safety and feasibility of tonsillectomy and/or adenoidectomy (T&A) in pediatric patients with prolonged activated partial thromboplastin time (APTT) and coagulation factor deficiency. Methods: A prospective study was admitted to the children undergoing T&A at our institution between October 2019 and January 2020, specifically focusing on preoperative coagulation function. Within this group, we identified 5 patients exhibiting prolonged APTT and coagulation factor deficiencies, constituting the experimental group, and 10 patients matched by gender and age with normal blood coagulation function were selected as the control group. Comparative analyses between the two groups were conducted, focusing on surgical duration, intraoperative bleeding volume, duration of hospital stay, and postoperative complications such as active bleeding across the groups. At the six-month postoperative mark, a reassessment of coagulation functions and factor assays was conducted within the experimental group. Results: No statistically significant differences were discovered in terms of surgical duration or bleeding volume when comparing the experimental subgroups with their respective control counterparts. Furthermore, there were no incidences of postoperative active bleeding observed in any of the groups. Notably, postoperative APTT values (32.7 ± 1.7s) exhibited a significant disparity compared to preoperative levels (43.7 ± 1.8s, p < 0.01). Coagulation factors demonstrated normalization, evidenced by a significant difference in postoperative Factor XII levels (40.2 ± 5.4%) compared to preoperative levels (63.1 ± 5.9%, p < 0.01). Conclusion: Prolonged APTT with FXII factor deficiency does not show a significant bleeding tendency and is not a contraindication for T&A surgery. Post T&A surgery, children with abnormal coagulation function and deficient clotting factors show significant improvement compared to pre-surgery. It is important to consider that chronic inflammation in adenoids and tonsils may contribute to the prolongation of APTT and the manifestation of Factor XII deficiency. [ABSTRACT FROM AUTHOR]

Background: Chamomile administration may have desirable effects in the perioperative setting. Current practice, however, discourages perioperative chamomile use due to a theoretical increase in bleeding. Therefore, we evaluated if chamomile acutely (within 4 h of ingestion) prolongs coagulation assays. Methods: Eight healthy volunteers were randomized to receive 2 interventions in a crossover design: (a) single dose of chamomile extract capsule (500 mg) and (b) single dose of chamomile tea (3 g in 150 mL water). Interventions were separated at least 3 days apart from each other. Blood was sampled pre-ingestion, 2 h post-ingestion, and 4 h post-ingestion for each intervention. The primary outcome was the maximal change in prothrombin time (PT) before vs after each intervention. Secondary outcomes included changes in international normalized ratio, activated partial thromboplastin time, thrombin time, reptilase time, and fibrinogen levels. Results: All 8 subjects completed the study. The average pre-ingestion PT values for tea and capsules were 11.9 (1.1) s and 12.0 (0.9) s, respectively. Tea significantly increased the average maximum PT by 0.7 (0.2) s (P = 0.0078). Extract capsules increased the maximum PT by 0.3 (0.2) s (P = 0.06). Neither PT prolongation met the predefined 10% threshold for clinical significance. No significant changes in secondary outcomes were observed. Conclusions: Chamomile tea ingestion prolongs PT. However, the clinical significance of this is unclear at this time and warrants further investigation. ClinicalTrials.gov Registration Number: NCT05272475. [ABSTRACT FROM AUTHOR]

Background: Heart failure (HF) is a disease that poses a serious threat to individual health, and DNA methylation is an important mechanism in epigenetics, and its role in the occurrence and development of the disease has attracted more and more attention. The aim of this study was to evaluate the link between iodothyronine deiodinase 3 promoter region fragment FA27 (DIO3-FA27) methylation levels, biochemical indices, and HF. Results: The methylation levels of DIO3-FA27_CpG_11.12 and DIO3-FA27_CpG_23.24 significantly differed in HF patients with different degrees. Multivariate logistic regression analysis indicated that the relative HF risk in the third and fourth quartiles of activated partial thromboplastin time and fibrin degradation products. The results of the restricted cubic spline model showed that the methylation levels of DIO3-FA 27_CpG_11.12 and DIO3-FA 27_CpG_23.24 were associated with coagulation indicators, liver function, renal function, and blood routine. Conclusions: Based on the differential analysis of CpG methylation levels based on DIO3-FA27, it was found that biochemical indicators combined with DIO3-FA27 promoter DNA methylation levels could increase the risk of worsening the severity classification of HF patients, which provided a solid foundation and new insights for the study of epigenetic regulation mechanisms in patients with HF. [ABSTRACT FROM AUTHOR]

Background: To analyze the relationship between lipid metabolism, coagulation function, and bone metabolism and the contributing factor and staging of non-traumatic femoral head necrosis, and to further investigate the factors influencing the blood indicators related to the staging of non-traumatic femoral head necrosis. Methods: The medical records of patients with femoral head necrosis were retrieved from the inpatient medical record management system, and the lipid metabolism, bone metabolism, and coagulation indices of non-traumatic femoral head necrosis (including alcoholic, hormonal, and idiopathic group) were obtained according to the inclusion and exclusion criteria, including Low-Density Lipoprotein Cholesterol, Triglycerides, Non-High-Density Lipoprotein Cholesterol, Apolipoprotein A1, Apolipoprotein (B), Apolipoprotein (E), Uric Acid, Alkaline Phosphatase, Bone-specific Alkaline Phosphatase, Activated Partial Thromboplastin Time, Prothrombin Time, D-dimer, Platelet count. The relationship between these blood indices and the different stages under different causative factors was compared, and the factors influencing the stages of non-traumatic femoral head necrosis were analyzed using multivariate logistic regression. Results: (i) Gender, Age and BMI stratification, Low-density Lipoprotein Cholesterol, Triglycerides, Non-High-density Lipoprotein Cholesterol, Apolipoprotein (B), Apolipoprotein (E), Uric Acid, Bone-specific Alkaline Phosphatase, Activated Partial Thromboplastin Time, Plasminogen Time, D-dimer, and Platelet count of the alcohol group were statistically different when compared among the different ARCO staging groups; (ii) The differences in Age and BMI stratification, Triglycerides, Non-High-density Lipoprotein Cholesterol, Apolipoprotein A1, Apolipoprotein B, Apolipoprotein E, Uric Acid, Bone-specific Alkaline Phosphatase, Activated Partial Thromboplastin Time, Plasminogen Time, D-dimer, and Platelet count were statistically significant when compared among the different phases in the hormone group (P < 0.05); (iii) The differences in Age and BMI stratification, Non-High-Density Lipoprotein Cholesterol, Apolipoprotein A1, Apolipoprotein (B), Apolipoprotein (E), Uric Acid, Activated Partial Thromboplastin Time, D-dimer, and Platelet count were statistically significant when compared among the different stages in the idiopathic group (P < 0.05); (v) Statistically significant indicators were included in the multivariate logistic regression analysis, excluding the highly correlated bone-specific alkaline phosphatase, and the results showed that Low-density lipoprotein was negatively correlated with changes in the course of ARCO, and Non-High-Density Lipoprotein cholesterol, Apo B, Activated Partial Thromboplastin Time, and Platelet count were significantly and positively correlated with disease progression. Conclusion: An abnormal hypercoagulable state as well as an abnormal hyperlipidemic state are risk factors for the progression of non-traumatic femoral head necrosis under various exposure factors, as indicated by Non-High-Density Lipoprotein Cholesterol, Apolipoprotein B, Activated Fractional Thromboplastin Time, and Platelet Counts. [ABSTRACT FROM AUTHOR]

Background. The lack of preceding research in Sudan emphasizes the importance of this study, which contributes critical data to the global understanding of sleep-related health effects. This study investigates the complex relationship between sleep deprivation and blood-related factors, particularly focusing on full blood count and coagulation parameters. Methods. From January to March 2022, a case-control study was conducted in Kosti, Sudan. A control group of 11 healthy 23–33-year-olds (6 men and 5 women) had regular sleep patterns. Six men and five women ages 23–33 were chosen for this sleep-deprived case study. The case group was deprived of sleep from 7:00 p.m. to 7:00 a.m. for three days and allowed to sleep normally during the day. Daily at 7:00 a.m., antecubital vein blood was drawn. The ACL 7000 coagulation analyzer and Sysmex fully automated hematology analyzers were used for coagulation and whole blood count analysis. Data analysis included descriptive and inferential approaches like the Mann–Whitney U test for group comparisons. Results. The study found no significant differences in total white blood cell counts reported between case and control groups (p = 0.898). The case group had a substantial drop in lymphocyte counts on day 3 (p = 0.016). The third day showed significant differences in neutrophil and eosinophil levels (p = 0.003 and 0.000, respectively). The difference in hemoglobin and hematocrit on day 3 was statistically significant (p = 0.023). Platelet counts were stable. Both groups' prothrombin times were unaffected. On all three days, groups had significant differences in activated partial thromboplastin time (APTT) (p = 0.004). Therefore, the intrinsic coagulation system may have changed. Conclusion. This study demonstrates the complex link between sleep deprivation, coagulation indicators, and complete blood count. Monitoring blood indicators in poor sleep helps explain fundamental mechanisms and medicinal implications. [ABSTRACT FROM AUTHOR]