Platelets

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  • Despite my many years of research and teaching in platelet physiology and pharmacology at the University of Minnesota, I am often confronted with conflicting opinions as to the relevance of nonnucleated platelets in human health and disease. It is fascinating to think that how cells with no apparent nucleus, have such a towering impact on concepts, dealing with often overlapping physiological (i.e. hemostasis, wound healing, etc.) and pathophysiological (i.e. thrombosis, stroke, atherosclerosis, wound healing, diabetes, inflammation and cancer) components.

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  • Harrison's Internal Medicine Chapter 109. Disorders of Platelets and Vessel Wall Disorders of Platelets and Vessel Wall: Introduction Hemostasis is a dynamic process in which the platelet and the blood vessel wall play key roles. Platelets become activated upon adhesion to von Willebrand factor (vWF) and collagen in the exposed subendothelium after injury. Platelet activation is also mediated through shear forces imposed by blood flow itself, particularly in areas where the vessel wall is diseased, and is also affected by the inflammatory state of the endothelium.

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  • Thrombocytopenia Thrombocytopenia results from one or more of three processes: (1) decreased bone marrow production; (2) sequestration, usually in an enlarged spleen; and/or (3) increased platelet destruction. Disorders of production may be either inherited or acquired. In evaluating a patient with thrombocytopenia, a key step is to review the peripheral blood smear and to first rule out "pseudothrombocytopenia," particularly in a patient without an apparent cause for the thrombocytopenia. Pseudothrombocytopenia (Fig.

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  • Approach to the Patient: Thrombocytopenia The history and physical examination, results of the CBC, and review of the peripheral blood smear are all critical components in the initial evaluation of the thrombocytopenic patients (Fig. 109-2). The overall health of the patient and whether he/she is receiving drug treatment will influence the differential diagnosis. A healthy young adult with thrombocytopenia will have a much more limited differential diagnosis than an ill hospitalized patient who is receiving multiple medications.

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  • Table 109-1 Drugs Definitively Reported to Cause Isolated Thrombocytopeniaa Abciximab Digoxin Acetaminophen Eptifibatide Acyclovir Hydrochlorothiazide Aminosalicylic acid Ibuprofen Amiodarone Levamisole Amphotericin B Octreotide Ampillicin Phenytoin Carbamazepine Quinine Chlorpropamide Rifampin Danazol Tamoxifen Diatrizoate meglumine (Hypaque Meglumine) Tirofiban Trimethoprim/sulfamethoxazole Diclofenac Vancomycin a Drugs that preceded thrombocytopenia and full recovery occurred after drug discontinuation, but recurred with re-introduction of the drug, and ot...

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  • Laboratory Testing for HIT HIT (antiheparin/PF4) antibodies can be detected using two types of assays. The most widely available is an enzyme-linked immunoassay (ELISA) with PF4/polyanion complex as the antigen. Since many patients develop antibodies but do not develop clinical HIT, the test has a low specificity for the diagnosis of HIT. This is especially true in patients who have undergone cardiopulmonary bypass surgery, where approximately 50% of patients develop these antibodies postoperatively.

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  • Immune Thrombocytopenic Purpura: Treatment The treatment of ITP utilizes drugs that decrease reticuloendothelial uptake of the antibody-bound platelet and/or decrease antibody production. However, the diagnosis of ITP does not necessarily mean that treatment must be instituted. Patients with platelet counts 30,000/µL appear not to have increased mortality related to the thrombocytopenia.

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  • von Willebrand Disease vWD is the most common inherited bleeding disorder. Estimates from laboratory data suggest a prevalence of approximately 1%, but data based on symptomatic individuals suggest that it is closer to 0.1% of the population. vWF serves two roles: (1) as the major adhesion molecule that tethers the platelet to the exposed subendothelium; and (2) as the binding protein for FVIII, resulting in significant prolongation of the FVIII half-life in circulation.

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  • Patients with type 2 vWD have functional defects; thus, the vWF antigen measurement is significantly higher than the test of function. For types 2A, 2B, and 2M, vWF activity is decreased, measured as ristocetin cofactor or collagen binding activity. In type 2A vWD, the impaired function is due either to increased susceptibility to cleavage by ADAMTS13, resulting in loss of intermediate- and high-molecular weight (M.W.) multimers, or to decreased secretion of these multimers by the cell.

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  • To study the clinical and paraclinical characteristics of primary knee osteoarthritis. To assess the effectiveness and safety of autologous platelet-rich plasma therapy in treament of primary knee osteoarthritis.

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  • - PRP (1970) - Recent technologic advances : the hospital  outpatient and ambulatory surgical centers…even into physicians’ offices. The following growth factors can be found in the environment of a blood clot: - Transforming growth factor beta (TGF-b) - Platelet-derived growth factor (PDGF) - Insulin-like growth factor (IGF) - Vascular endothelial growth factors (VEGF) - Epidermal growth factor (EGF) - Fibroblast growth factor-2 (FGF-2)

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  • In Europe, and more recently in the United States, an increased trend has emerged in the use of autologous blood products in an effort to facilitate healing in a variety of applications. In recent years, scientific research and technology has provided a new perspective on understanding the wound healing process. Initially platelets were thought to act exclusively with clotting.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Tirofiban preserves platelet loss during continuous renal replacement therapy in a randomised prospective open-blinded pilot study...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Self Assembly and Properties of C:WO3 Nano-Platelets and C:VO2/V2O5 Triangular Capsules Produced by Laser Solution Photolysis

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Novel agents for anti-platelet therapy...

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Rac1-mediated signaling plays a central role in secretion-dependent platelet aggregation in human blood stimulated by atherosclerotic plaque

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  • Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Platelet-activating factor enhancement of calcium influx and interleukin-6 expression, but not production, in human microglia

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  • To facilitate feeding, certain hematophagous invertebrates possess inhibi-tors of collagen-induced platelet aggregation in their saliva. However, their mechanisms of action have not been fully elucidated. Here, we describe two major salivary proteins, triplatin-1 and -2, from the assassin bug, Tria-toma infestans, which inhibited platelet aggregation induced by collagen but not by other agents including ADP, arachidonic acid, U46619 and thrombin.

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: A polymorphism in the human serotonin 5-HT2A receptor gene may protect against systemic sclerosis by reducing platelet aggregation...

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  • Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Platelet-derived exosomes induce endothelial cell apoptosis through peroxynitrite generation: experimental evidence for a novel mechanism of septic vascular dysfunction...

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