Hemorrhages

Hemophilia A Hemophilus influenzae Hemorrhage Hemorrhoids Hemosiderin Hemo stats Hemp... 

Ergonovine (100, R = NHCH(CH3)CH2 0H) was found to yield lysergic acid (100, R = OH) and (+)-2-aminopropanol on alkaline hydrolysis during the early analysis of its stmcture (66) and these two components can be recombined to regenerate the alkaloid. Salts of ergonovine with, for example, malic acid are apparently the dmgs of choice in the control and treatment of postpartum hemorrhage. 

Intoxication by aflatoxkis is referred to as aflatoxicosis. Edema and necrosis of hepatic and renal tissues seem characteristic of aflatoxicosis, and hemorrhagic enteritis accompanied by nervous symptoms often appear ki experimental animals. The mode of action of aflatoxkis kivolve an kiteraction with DNA and inhibition of the polymerases responsible for DNA and RNA synthesis (96). 

They release adenosine diphosphate [58-64-0 (ADP) and thromboxane [57576-52-0] which results in vascular contraction and, indirectiy, in the formation of fibrin clot. Platelet transfusions are indicated for patients with thrombocytopenia, ie, a shortage of healthy platelets or thrombocytopathy, ie, platelet malignancy associated with spontaneous hemorrhages. 

Most iron salts and compounds may be safely handled following common safe laboratory practices. Some compounds are irritants. A more serious threat is ingestion of massive quantities of iron salts which results in diarrhea, hemorrhage, fiver damage, heart damage, and shock. A lethal dose is 200 250 mg/kg of body weight. The majority of the victims of iron poisoning are children under five years of age. 

Clinically, GM-CSF or G-CSF have been used to accelerate recovery after chemotherapy and total body or extended field irradiation, situations that cause neutropenia and decreased platelets, and possibly lead to fatal septic infection or diffuse hemorrhage, respectively. G-CSF and GM-CSF reproducibly decrease the period of granulocytopenia, the number of infectious episodes, and the length of hospitalization in such patients (152), although it is not clear that dose escalation of the cytotoxic agent and increased cure rate can be rehably achieved. One aspect of the effects of G-CSF and GM-CSF is that these agents can activate mature cells to function more efficiently. This may, however, also lead to the production of cytokines, such as TNF- a, that have some toxic side effects. In general, both cytokines are reasonably well tolerated. The side effect profile of G-CSF is more favorable than that of GM-CSF. Medullary bone pain is the only common toxicity. 

These agents are often combined with a vasoconstrictant such as epinephrine [51-43-4]. By using such a combination, the local anesthetic is held in the area for a longer period of time and its effect extended hemorrhage is minimized, blood loss prevented, and a better surgical repair obtained. 

Aplastic anemia and leukemia are not the only health effects ascribed to benzene exposure. A number of recent studies have associated benzene exposure with chromosomal changes (aberrations) (118). Other studies have shown abnormalities in porphyrin metabolism and decrease in leucocyte alkaline phosphatase activity in apparendy healthy workers exposed to 10—20 ppm benzene (119,120). Increases in leukoagglutinins, as well as increases in blood fibrinolytic activity, have also been reported and are believed to be responsible for the persistent hemorrhages in chronic benzene poisoning (121,122). 

World War II ushered ia the modem era of blood fractionation. It was shown that plasma could be adniinistered directiy to humans (23,24). Although cases of semm sickness frequendy occurred five to seven days after the iafusion, the procedure could be life-saving ia cases of hemorrhagic shock (see Fractionation, blood) (25). 

The hemorrhagic diathesis in patients with coagulation disorders is because of either an abnormaUty of one or more plasma proteins and/or platelets necessary for normal blood coagulation or the spontaneous presence of a circulating anticoagulant. Specific laboratory techniques are required for the precise identification of these disorders. 

Congenital deficiency of Factor XI is a relatively rare coagulopathy that has been reported as both an autosomal dominant and autosomal recessive trait. This deficiency state occurs predominantly in the Jewish population. Most patients with this deficiency state remain asymptomatic until trauma or surgery is encountered. Spontaneous hemorrhage is rare in this population. 

Congenital deficiency of Factor Xlll is inherited as an autosomal recessive trait and is frequendy recognized at birth because of delayed persistent hemorrhage from the umbiUcus. In Factor Xlll-deficient people wound healing is defective and wound dehiscence is common. 

The mortahty is usually reduced from 12% in the control group to 9—10% in the streptokinase group. Side effects are bleeding and hemorrhage, fever, and in rare occasions, anaphylaxis. 

Choline was isolated from ox bile in 1849 by Strecker. During 1900 to 1920, observations led to interest in the vasodepressor properties of the esters of choline, and in the 1920s it was shown that acetylcholine was presumably the "vagus-substance." The nutritional importance of choline was recognized in the 1930s, when it was found that choline would prevent fatty infiltration of the Hver in rats. Subsequent observations showed that choline deficiency could produce cirrhosis (1) or hemorrhagic kidneys (2) in experimental animals under various conditions. 

The side effects of anistreplase appear to be similar to those of streptokinase, including immune reactions and a systemic lytic state conductive to hemorrhage. 

Untoward effects of both E and NE (usually to a lesser degree) are anxiety, headache, cerebral hemorrhage (from vasopressor effects), cardiac arrhythmias, especially in presence of digitaUs and certain anesthetic agents, and pulmonary edema as a result of pulmonary hypertension. The minimum subcutaneous lethal dose of E is about 4 mg, but recoveries have occurred after accidental overdosage with 16 mg subcutaneously and 30 mg intravenously, followed by immediate supportive treatment. 

Spotnitz, W.D., Dalton, M.S., Baker, J.W. and Nolan, S.P, Reduction of perioperative hemorrhage by anterior mediastinal spray application of fibrin glue during cardiac operations. Ann. Thorac. Surg., 44, 529-531 (1987). 

---