Envenomations that are caused by Viperidae snakebites are mostly accompanied by venom-induced consumption coagulopathy (VICC) with defibrination. The clinical course of VICC is well described; however, reports about its detailed effects in the hemocoagulation systems of patients are sparse. In this pilot study, we prospectively analyzed the changes in plasma fibrinogen that were caused by the envenomation of six patients by five non-European Viperidae snakes. Western blot analysis was employed and fibrinogen fragments were visualized with the use of specific anti-human fibrinogen antibodies. All of the studied subjects experienced hypo- or afibrinogenemia. The western blot analysis demonstrated fibrinogenolysis of the fibrinogen chains in all of the cases. Fibrinogenolysis was considered to be a predominant cause of defibrination in Crotalus, Echis, and Macrovipera envenomation; while, in the cases of VICC that were caused by Atheris and Calloselasma envenomation, the splitting of the fibrinogen chains was present less significantly.
Coagulopathy with defibrination is one of symptoms accompanying snakebite envenoming, where life-threatening complications such as massive bleeding and organ hematomas formation can occur. Here, we report a case of hemocoagulation failure due to bite by African Great Lakes bush viper Atheris nitschei with impossibility of specific treatment for absence of antivenom and its life-threatening complication: very rare and unexpected atraumatic splenic rupture with massive hemoperitoneum and necessity of urgent splenectomy.
1. elektronické vydání 1 online zdroj (146 stran)
Kniha představuje ucelený přehled informací o základních strukturách centrálního nervového systému a jejich funkčního spojení. Text je členěn do 11 kapitol a je určen především pro studenty pregraduálního studia medicíny. Každá kapitola obsahuje textovou část, originální schématické obrázky a přehledné tabulky, které umožňují lépe se orientovat ve složité stavbě mozku a míchy člověka. Součástí textu jsou klinické poznámky, které vhodným způsobem zdůrazňují význam znalosti stavby centrálního nervstva pro lepší pochopení jeho funkce a jeho poruch.
- Klíčová slova
- Ostatní lékařské obory,
- MeSH
- centrální nervový systém anatomie a histologie MeSH
Učební texty Karlovy Univerzity
Vydání první 145 stran : ilustrace, tabulky ; 23 cm
Učebnice pro vysokoškolské studenty. Zaměřuje se na základní anatomii centrálního nervového systému.
- Konspekt
- Anatomie člověka a srovnávací anatomie
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- anatomie
- neurovědy
- NLK Publikační typ
- učebnice vysokých škol
OBJECTIVE: Viperidae snakes are responsible for 95 % of the bites caused by exotic-bred snakes in our country. Their envenoming may be associated with a severe acute coagulation disorder – venom-induced consumption coagulopathy (VICC). Thus, its early prediction is vital for an adequate therapy including antivenom delivery.MATERIAL AND METHODS: Laboratory coagulation tests of 14 patients suffering from VICC were processed and statistically analyzed to evaluate the importance of individual parameters in the time after the bite.RESULTS: The pathological values of D-dimer (D-dim) and fi brinogen (FBG) were found to be the fi rst indica-tors of VICC development, with a median time of 4.55 hours since the bite, while median values for prothrombin time and international normalized ratio (PT/INR), activated partial thromboplastin time (APTT), and thrombin time (TT) were 5.9 h, 8.15 h, and 5.5 h, respectively. In the first samples, the values of D-dim were found to be pathologically increased in all 14 patients, while pathological levels of FBG were seen only in 11 cases. PT/INR and APTT were prolonged in 8 and 6 cases, respectively. CONCLUSION: An increase in D-dim values was found to be the first parameter signaling developing VICC in all analyzed cases (Tab. 2, Ref. 12). Text in PDF www.elis.sk.
Učební texty Univerzity Karlovy
Vydání druhé 123 stran : ilustrace ; 23 cm
Skripta předpokládají teoretické znalosti, a proto základní anatomické údaje, známé již ze systematické anatomie, jsou stručně uváděny jen u některých krajin. Schematické obrázky mají jednak charakter návodu k preparaci (kožní řezy, rozstřižení srdce apod.), jednak ukazují obsah krajin zobrazených z běžně užívaného přístupu. Nakladatelská anotace. Kráceno
- Konspekt
- Patologie. Klinická medicína
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- anatomie
Učební texty Univerzity Karlovy
Second edition 109 stran : ilustrace ; 30 cm
- Konspekt
- Anatomie člověka a srovnávací anatomie
- Učební osnovy. Vyučovací předměty. Učebnice
- NLK Obory
- anatomie
- NLK Publikační typ
- učebnice vysokých škol
Activation of detectors and phantoms used for commissioning and quality assurance of clinical proton beams may lead to radiation protection issues. Good understanding of the activation nuclide vectors involved is necessary to assess radiation risk for the personnel working with these devices on a daily basis or to fulfill legal requirements regarding transport of radioactive material and its release to the public. 11 devices and material samples were irradiated with a 220 MeV proton pencil beam (PBS, Proton Therapy Center, Prague). This study focuses on devices manufactured by IBA Dosimetry GmbH: MatriXX PT, PPC05, Stingray, Zebra, Lynx, a Blue Phantom rail and samples of RW3, PMMA, titanium, copper and carbon fibre plastic. Monitor units (MU) were monitored during delivery. Gamma spectrometry was then performed for each item using a HPGe detector, with a focus on longer lived gamma emitting radionuclides. Activities were quantified for all found isotopes and compared to relevant legal limits for exemption and clearance of radioactive objects. Activation was found to be significant after long irradiation sessions, as done during commissioning of a proton therapy room. Some of the investigated devices may also cumulate activity in time, depending on the scenario of periodic irradiation in routine clinical practice. However, the levels of activity and resulting beta/gamma doses are more comparable to internationally recommended concentration limits for exemption than to dose limits for radiation workers. Results of this study will help to determine nuclide inventories required by some legal authorities for radiation protection purposes.
