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001-es BibID:BIBFORM048836
Első szerző:Csorba Roland (szülész-nőgyógyász, gyermeknőgyógyász)
Cím:Rheological parameters in the umbilical cord blood in moderate and severe forms of preeclampsia / Roland Csorba, Asli Yilmaz, Panagiotis Tsikouras, Christian Wieg, Alexander Teichmann, Georg-Friedrich von Tempelhoff
Dátum:2013
ISSN:1386-0291
Megjegyzések:Previous studies have dealt with maternal blood rheology in preeclampsia (PE), but only a few focused on the fetal rheological parameters in this maternal state. PE is one of the most common severe complications of pregnancy world-wide associated with high maternal morbidity and mortality and intrauterine fetal growth restriction. Our objective was to explore the rheological parameters in the umbilical cord blood at term in the presence of moderate and severe forms of PE.METHODS:A subgroup analysis was performed in a community based retrospective study of 4,951 consecutively recorded singleton pregnant women of whom 423 had PE. In the latter, umbilical cord blood was collected during delivery for testing of hematological and blood rheological parameters of their fetus. Fetal results from uneventful pregnancy were compared with those associated with preeclampsia. Furthermore, results were also evaluated in the presence of moderate and severe forms of PE. Plasma viscosity (pv) was examined using KSPV 1 Fresenius and Red Blood Cell (RBC) aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne.RESULTS:According to the definition of the German Society of Gynecology and Obstetrics (DGGG) 314 women had moderate (74.2%), while 109 had severe forms of PE due to the presence of a blood pressure > 170/110 mmHg (n = 41; 9.7%), and/or IUGR < 5th percentile (n = 28; 6.6%), and/or HELLP-Syndrome (n = 10; 2.4%), and/or proteinuria ? 5 g/24 h (n = 30; 7.1%). When comparing the fetal results from pregnancies with and without preeclampsia mean hemoglobin values (p < 0.001) and hematocrit (p < 0.001) were markedly higher, while plasma viscosity (p = 0.006) and erythrocyte aggreagtion (stase: p = 0.35; low shear: p = 0.08) were lower in association with preeclampsia. Gestational age, fetal birth-weight and umbilical arterial cord blood pH in women with severe PE was statistically significant lower as compared to those with moderate disease (p < 0.001). Mean hemoglobin level and hematocrit were higher in fetus from women with severe compared to moderate PE, while plasma viscosity (1.03 ? 0.07 mPas vs. 1.05 ? 0.07; p = 0.05) and erythrocyte aggregation in stase (2.3 ? 2.47 vs. 2.41 ? 2.46; p = 0.11) as well as under low shear (7.86 ? 4.63 vs. 8.06 ? 4.60; p = 0.15) were lower. HELLP-Syndrome was associated with the lowest plasma viscosity (1.00 ? 0.07 mPas; p = 0.019) and erythrocyte aggregation (low shear: 5.1 ? 5.0; p = 0.04) in fetus.CONCLUSION:The results of this study including a notable number of patients with PE and their newborns revealed an in part statistically significant association between variables of blood rheology and the presence, severity and type of preeclampsia with a trend towards hyper viscosity in severe forms of preeclampsia. The behaviour of blood rheological components in the neonate is remarkable since the number of red blood cells is raised while RBC aggregability and plasma viscosity is low.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Pregnancy
fetal hemorheology
plasma viscosity
preeclampsia
red blood cell aggregation
Megjelenés:Clinical Hemorheology and Microcirculation 55 : 4 (2013), p. 391-401. -
További szerzők:Yilmaz, Asli Tsikouras, Panagioti Wieg, Christian Teichmann, Alexander Tempelhoff, Georg-Friedrich von
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2.

001-es BibID:BIBFORM048838
035-os BibID:(WoS)000429590100003 (Scopus)85047832575
Első szerző:Soliman, Amr A.
Cím:Neonatal blood rheological parameters at delivery in healthy neonates and in those with morbidities / Amr A. Soliman, Roland Csorba, Pagnaioti Tsikouras, Christian Wieg, Harald Harnack, Georg-Friedrich von Tempelhoff
Dátum:2018
ISSN:1386-0291 1875-8622
Megjegyzések:Rheological blood parameters of neonates are different form those of adults. Many authors have studied changes in blood rheology in neonates in different clinical disorders. To-date, no one set the normal values for blood rheological parameters in healthy neonates. The aim of this study is to set the norm for rheological blood parameters in healthy newborns and to describe the changes in those parameters in common clinical disorders that affect the newborns. We recruited all the neonates born to mothers experiencing un eventful pregnancies, blood was taken from the umbilical cord right after the delivery. In this time period we recruited 4985 neonate. From this huge database we were able to set the standards for blood rheology in neonates, namely plasma viscosity of 1.06 ? 0.072 mPa, erythrocyte aggregation at stasis of 2.41 ? 2.74 s-1 and erythrocyte aggregation under low shear forces of 8.51 ? 6.38 s-1. These values changed significantly in some diseased neonates. This is the largest study investigating normal rheological parameters and deviations from the norm in common clinical disorders occurring in this early stage of life.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Neonate
blood rheology
SGA
LBW
red blood cell aggregation
Megjelenés:Clinical Hemorheology and Microcirculation. - 68 : 4 (2018), p. 335-345. -
További szerzők:Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász) Tsikouras, Panagioti Wieg, Christian Harnack, Harald Tempelhoff, Georg-Friedrich von
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3.

001-es BibID:BIBFORM048839
035-os BibID:PMID:23089882
Első szerző:Soliman, Amr A.
Cím:Rheologic results and their correlation to hemostatic changes in patients with moderate and severe preeclampsia : an observational cross-sectional study / Amr A. Soliman, Roland Csorba, Asli Yilmaz, Georg-Friedrich von Tempelhoff
Dátum:2015
ISSN:1386-0291
Megjegyzések:Previous study have shown an association between failure of physiological hemodilution during 2nd trimester and an increased risk for the development of subsequent pregnancy complications such as early birth, birth of a growth retarded newborn (IUGR), low fetal birth weight and preeclampsia. The latter complication in particular goes along with dramatic changes in the placental perfusion as well as systemic maternal blood flow. Severity of preeclampsia may be preceded by distinct impaired hemodilution and reflected by the results of rheological parameters. A subgroup analysis was performed in a community based retrospective study of 4,985 consecutively recorded singleton pregnant women of whom 423 had preeclampsia. Mean 2nd trimester hemoglobin levels and blood rheological results at the time of delivery were assessed and compared in women with moderate and severe preeclampsia. Mean 2nd trimester hemoglobin levels were calculated from the maternal records. Rheological variables included plasma viscosity (KSPV 1 Fresenius) and Red blood cell aggregation in stasis and under low shear conditions (MA1-Aggregometer; Myrenne). According to the definition of the German Society of Gynecology and Obstetrics (DGGG) 314 women had moderate preeclampsia (74.2%), while 109 had severe preeclampsia due to the presence of a blood pressure >170/110 mmHg (n = 41; 9.7%), and/or IUGR <5th percentile (n = 28; 6.6%), and/or HELLP-Syndrome (n = 10; 2.4%), and/or proteinuria ?5 g/24 h (n = 30; 7.1%). Age, BMI, smoking, and maternal weight were comparable in the groups, while gestational age at delivery as well as fetal outcome parameter were statistically significant unfavourable in patients with severe preeclampsia. Mean 2nd trimester hemoglobin level were statistically significantly higher in women who developed severe vs. moderate preeclampsia (m = 12.75 ? 0.99 g/dL vs. m = 12.50 ? 1.05 g/dL; p = 0.033). However, in the ROC calculations a hemoglobin value of 12.05 g/dL revealed best sensitivity (78%) and specificity (33.8%) in women with subsequent diagnosis of severe preeclampsia, whereas sensitivity was 100% for a value >10.95 g/dL. There were no statistically significant differences for none of the rheological parameters at the time of delivery between groups of patient with moderate v.s severe preeclampsia. Severe preeclampsia and IUGR, however, was associated with statistically significantly higher RBC aggregation as compared to patients with moderate preeclampsia. Plasma viscosity was statistically significantly (p < 0.05) correlated with Fibrinogen values (r = 1.69), leukocyte-(r = 0.11) and platelets-count (r = 0.127), and hemoglobin/hematocrit values in particular (r = 0.23/0.26). Although mean 2nd trimester hemoglobin concentration are higher in patients with subsequent development of severe preeclampsia, due to the low sensitivity and specificity of this parameter clinical use for identifying women at risk is of limited value. On the other hand, a hemoglobin value below 11.0 g/dL excluded the risk for severe preeclampsia to 100%. Blood rheological parameters at the time of delivery in the absence of IUGR are not markedly influenced by severity of preeclampsia.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Blood fluidity
haemostasis
pregnancy
preeclampsia
red blood cell aggregation
Megjelenés:Clinical Hemorheology and Microcirculation. - 59 : 1 (2015), p. 1-15. -
További szerzők:Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász) Yilmaz, Asli Tempelhoff, Georg-Friedrich von
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4.

001-es BibID:BIBFORM072235
Első szerző:Tempelhoff, Georg-Friedrich von
Cím:Thrombelastometric results and platelet function during pregnancy in women receiving low molecular weight heparin with a history of recurrent/late abortion : a retrospective analysis / von Tempelhoff Georg-Friedrich, Schelkunov Olga, Demirhan Attila, Tsikouras Panagiotis, Rath Werner, Velten Eva, Csorba Roland
Dátum:2015
ISSN:1386-0291
Megjegyzések:In women with a history of recurrent/late abortion and confirmed genetic/acquired thrombophilia, LMWH was given during subsequent pregnancy and serial coagulation testing was performed. In 82 consecutive pregnant women with recurrent (?2) and/or late abortion (>12 GW) in the presence of single (n = 62; 75.6) or combined (n = 20; 24.4) genetic and/or acquired thrombophilia, Thromboelastometry (n = 50; ROTEM, TEM) and closure-time (n = 82; PFA-100; Siemens) underwent serial testing before and during pregnancy while receiving LMWH and puerperal. Throughout pregnancy, clotting-time (CT) after intrinsic and extrinsic induced coagulation activation in Thromboelastometry remained unchanged. TF-induced coagulation activation resulted in statistically significantly decreased mean clot-formation-times (CFT) (Trim I: 108.9 ? 5.2 S to Trim III; 81.7 ? 5.4 S; p = 0.001), whereas after contact activation (Intem-S: Trim I: 70.1 ? 4.0 S to Trim III: 65.4 ? 6.8; n.s.) CFT remained unchanged. Mean maximal-clot-firmness (MCF) continuously increased in the Intem-S and Extem-S during each trimester and decreased until 4th puerperal week (Extem-S: Trim I: 61.9 ? 1.0 S; Trim II: 65.4 ? 0.58 S; Trim III: 68.3 ? 1.1 S; p < 0.001; Intem-S: Trim I: 64.1 ? 0.6 S; Trim II: 66.8 ? 0.5 S; Trim III: 69.5 ? 1.2 S; p < 0.001). Mean Closure-times after Epinephrine/ADP/Collagen stimulation remained unchanged during pregnancy. In women with different thrombophilia receiving LMWH at prophylactic dose a significant increase in MCF was accompanied by barely unchanged CT after intrinsic and extrinsic coagulation activation and platelet mediated closure-times in the course of the pregnancy. Decrease in CFT was only seen after extrinsic coagulation activation, whereas unchanged CFT after intrinsic coagulation activation may be the result of LMWH given at low dose.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
low-molecular-weight-heparin
platelet-function-analyser
Pregnancy
recurrent abortion
Thromboelastometry
Megjelenés:Clinical Hemorheology And Microcirculation 61 : 1 (2015), p. 99-110. -
További szerzők:Schelkunov, Olga Demirhan Attila Tsikouras, Panagioti Rath, Werner Velten, Eva Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász)
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5.

001-es BibID:BIBFORM072234
035-os BibID:(Wos)000371008900006 (Scopus)84959020058
Első szerző:Tempelhoff, Georg-Friedrich von
Cím:Correlation between blood rheological properties and red blood cell indices(MCH, MCV, MCHC) in healthy women / von Tempelhoff Georg-Friedrich, Schelkunov Olga, Demirhan Attila, Tsikouras Panagiotis, Rath Werner, Velten Eva, Csorba Roland
Dátum:2016
ISSN:1386-0291
Megjegyzések:OBJECTIVE: Structure and mechanical properties of red blood cells are markedly influenced by pathophysiology of many diseases which in turn potentially impair microcirculatory blood flow. The physiological association between blood rheological parameters and red blood cell indices was investigated in otherwise healthy unselected mid-age women prior to elective gynaecological surgery. METHODS: Red Blood Cell-deformability (RBC 1.2, 3.0; 6.0, 12.0; 30.0, 60.0) during exposure to low (RBC 1.2, 3.0), moderate (RBC 16.0, 12.0) and high shear forces (RBC 30.0, 60.0; Rheodyn; Myrenne), -aggregation (MA1; Myrenne) during low shear (E1; 4-1 S) and in stasis (E0) and plasma viscosity (Pv; KSV 1; Fresenius) were correlated with red blood cell indices (RBC-I: MCV, MCH and MCHC) and subjects' characteristics in 286 healthy women the day before undergoing gynaecologic standard surgery. Women with known pregnancy, malign-, infective-, chronic-disease or extreme BMI (<16; >40 Kg/m2) were excluded from this trial. RESULTS: From June 2014 to December 2014 a total of 286 healthy women (age: 46.5?17.6 y; BMI: 25.5?5.2 kg/m2) were eligible for inclusion into this prospective evaluation. Pv (mean?SD: 1.17?0.12 mPa s) and RBC aggregation (E0:12.6?6.3; E1:17.9?7.3) were not significantly correlated with RBC-I but with age and BMI. In contrast, RBC-deformability correlated significantly with MCV and MCH but significantly inversely correlated with MCHC. Deformability significantly increased with age but was unaffected by BMI of women. The correlation between RBC-I and RBC deformability was most remarkable during moderate shear force exposure. Neither haemoglobin nor haematocrit were correlated with RBC deformability or RBC-I. CONCLUSIONS: Cell volume and haemoglobin content had a strong impact on deformability in apparently healthy mid age women, whereas low MCHC and large MCV were associated with an increase in deformability while high MCHC and small MCV correlated with increased rigidity of RBC. BMI had no impact on deformability while age was associated with an increase in all determinants of blood viscosity. RBC aggregability was not affected by MCV, MCHC or MCH in mid-age women.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
MCHC
MCV
Plasma viscosity
red blood cell aggregation
red blood cell deformability MCH
Megjelenés:Clinical Hemorheology And Microcirculation. - 62 : 1 (2016), p. 45-54. -
További szerzők:Schelkunov, Olga Demirhan Attila Tsikouras, Panagioti Rath, Werner Velten, Eva Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász)
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6.

001-es BibID:BIBFORM072236
Első szerző:Tempelhoff, Georg-Friedrich von
Cím:Rheological, hemostaseological changes during immunetherapy for prevention of HELLP-syndrome in a patient with elevated phospholipid antibodies / von Tempelhoff Georg-Friedrich, Tsikouras Panagiotis, Rath Werner, Velten Eva, Csorba Roland
Dátum:2015
ISSN:1386-0291
Megjegyzések:OBJECTIVE: Patients with a history of severe obstetric complications in the presence of elevated phospholipid antibodies are at high risk for recurrent obstetric debacle. We report a successful immunologic treatment for prevention of HELLP-Syndrome in subsequent pregnancy in a patient with elevated Phospholipid antibodies, while under rheological and hemostaseological monitoring. METHODS: The patient with prior severe HELLP-Syndrome at term in the presence of reconfirmed elevated phospholipid antibodies in her first pregnancy received pooled immunoglobulins (Sandoglobulin 3 g - Novartis) intravenously for immunological treatment every three weeks in addition to low molecular weight heparin (Clexane 40 mg/d s.c.) and Aspirin (100 mg/d from 2nd trimester) during her subsequent pregnancy. Before each of 10 treatment cycles blood rheological parameters (Red Blood cell {RBC} aggregation stasis E0, low shear E1, RBC - deformability low-, moderate-, and high shear force, plasma viscosity {Pv}), as well as thrombelastometry (ROTEM) and in vitro platelet function (PFA-100) for hemostaseological evaluation was performed. At the same times non-invasive, physical thrombosis screening took place using impedance plethysmography (Filtrass) RESULTS: During pregnancy a constant increase in PV and E1 (>45 S-1) was accompanied by a delayed but continuous increase in RBC deformability beginning at the end of the 2nd trimester. Thrombelastometry revealed a continuous reduction of clot formation time (CFT; extem: 84 to 38 sec) and an increase in maximal clot firmness (MCF; extem: 64 to 78 sec) after TF-induced coagulation activation while MCF and CFT after contact activation (intem) was barely unchanged. Platelet bleedingtime after EPI/Coll stimulation was temporary prolonged by the onset of Aspirin intake (>300 sec) but normalized soon after 20th gestational week, while ADP/Coll stimulation revealed a trend towards prolonged bleeding times at the same time. There was a strong and statistically significant inverse correlation between E1 and TF induced CFT (r =-0.82; p = 0.002) and a positive correlation between E1 and TF induced MCF (r = 0.89; p < 0.001), while the correlation between E1 and contact activated CFT and MCF was weak or absent, respectively. Until GW 38th routine laboratory- (Platelet-count, Haptoglobin, liver enzymes) and clinical findings remained normal, without evidence of HELLP-Syndrome reoccurrence or development of thrombosis. CONCLUSIONS: During immunotherapy in this high risk patient HELLP-Syndrome did not reoccur. The aggregability of RBC was closely related with the formation speed and firmness of clot after TF activated coagulation but not after contact activated coagulation. At the beginning of 3rd trimester RBC aggregation remained dramatically higher as compared to the normal value range of pregnant women found in a large recent trial which may have been an early indicator of imminent HELLP-Syndrome.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
antiphospholipid syndrome
HELLP syndrome
immunological treatment
plasma viscosity
platelet function
Pregnancy
red blood cell aggregation
thrombelastometry
Megjelenés:Clinical Hemorheology And Microcirculation 60 : 1 (2015), p. 123-131. -
További szerzők:Tsikouras, Panagioti Rath, Werner Velten, Eva Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász)
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7.

001-es BibID:BIBFORM073441
035-os BibID:(WoS)000436922100013 (Scopus)85047246921
Első szerző:Tsikouras, Panagioti
Cím:Blood rheology during normal pregnancy / Panagiotis Tsikouras, Barbara Niesigk, Georg-Friedrich von Tempelhoff, Werner Rath, Olga Schelkunov, Peter Daragó, Roland Csorba
Dátum:2018
ISSN:1386-0291
Megjegyzések:INTRODUCTION: Recent studies have shown increased RBC aggregation and no difference in plasma viscosity in thepresence ofmarkedly lower hematocrit inwomen at termcompared to non-pregnantwomen. Little is known about the outcomeof blood rheological parameters and red blood cell (RBC) deformability particularly in the course of normal pregnancy.METHODS: During a 36 months interval 1.913 blood samples were randomly collected from a total of 945 pregnantwomen in the course of their pregnancy (n = 1.259) and during puerperium (upto 1 week; n = 654). Next to the bloodcount, hemorheological parameters including red blood cell (RBC) -aggregation (stasis E0; low shear E1), -deformability(low, moderate and high shear conditions) and plasma viscosity (pv) were assessed. Plasma viscosity (pv) was examinedusing KSPV 1 Fresenius, RBC aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne and RBCdeformability (def) was determined by Rheodyn SSD Diffractometer, Myrenne, Roetgen, Germany were tested. In someof these women laboratory results prior to pregnancy (n = 145) were available which were compared with those duringpregnancy.RESULTS: Mean maternal pv remained unchanged within each trimester and compared to the values before pregnancyand during early puerperium (Range of means: 1.18?1.20mPa S). In contrast, RBC agg (E0 and E1) was markedly higherin the 2nd (21.8?7.0 and 28.9?9.4; p < 0.001) and 3rd trimester (18.74?8.4 and 28.2?9.4; p < 0.01) compared to thevalues before pregnancy (16.4?6.4 and 20?7.5) and during 1st trimester (17.49?6.5 and 22.4?7.4). There was a stat.significant temporary reduction in RBC def. under all shear rate conditions during 2nd trimester compared to the valuesbefore pregnancy which remained significantly lower during 3rd trimester only under high shear rates.An increase RBC agg was stat. significantly inversely correlated with reduced RBC def being most pronounced under lowshear rate conditions. While RBC rigidity was stat. significantly correlated with higher hematocrit values there was only aweak correlation between RBC agg and haematocrit (E0: r = ?0.084; p = 0.03; E1: r = ?0.06; p = 0.1). Pv was not correlatedwith haematocrit or RBC def but stat. significantly correlated with RBC agg.CONCLUSION: Blood rheological changesmanifest during 1st trimester, and fairly remain unchanged during 2nd trimesteruntil term. Physiologic hemodilution and increasing hypercoagulability is accompanied by high RBC -aggregation and?rigidity during 2nd trimester while plasma viscosity remains nearly unaffected throughout normal pregnancy.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Clinical Hemorheology and Microcirculation. - 69:1-2 (2018), p. 101-114. -
További szerzők:Niesigk, Barbara Tempelhoff, Georg-Friedrich von Rath, Werner Schelkunov, Olga Daragó Péter Csorba Roland (1972-) (szülész-nőgyógyász, gyermeknőgyógyász)
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