On Jun 26, 9:16*am, ironjustice wrote:
Pre-Flight Testing Urged for All Travelers With Restrictive Lung
Disease
"Chelating agents to facilitate thrombolysis"
Modification of fibrin structure as a possible cause of thrombolytic
resistance
Journal of Thrombosis and Thrombolysis
Boguslaw Lipinski1
(1) Department of Genetics and Epidemiology, Joslin Diabetes Center,
Harvard Medical School, Boston, MA 02215, USA
Published online: 24 June 2009
Abstract
This paper presents a concept according to which free radicals,
specifically
the most biologically active hydroxyl radicals, induce structural
modifications
in fibrin(ogen) molecules making them resistant to proteolytic
degradation.
Such changes are analogous to those in congeneticaly altered
fibrinogen that
give rise to plasmin resistant fibrin clots and consequently to
thrombosis.
In view of the fact that hydroxyl radicals are generated in the Fenton
reaction
in the presence of iron and/or copper ions, the use of chelating
agents to
facilitate thrombolysis is rationalized.
Moreover, the resistance of thrombi older than 3 h to proteolytic
degradation
may be abrogated by the administration of free radical scavengers,
particularly
those that can be neutralized by virtue of aromatic hydroxylation,
such as
salicylates and polyphenolic compounds.
Keywords Free radicals - Fibrin(ogen) - Proteolysis - Chelating
agents -
Free radical scavengers
Boguslaw Lipinski
Email:
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Deep Vein Thrombosis FAQ
Question: What is Deep Vein Thrombosis.?
Answer: DVT is the name given to a blood clot that forms
in a vein, most commonly in the calf. On a plane, DVT
can be caused partly by dehydration - it gets very dry
in planes and the blood becomes thicker than usual - and
by not moving about.
Long-haul, direct flights may carry the biggest risk
because there is less opportunity to move around.
Question: What happens.?
Answer: A combination of inactivity, sluggish
circulation and thicker blood results in a clot forming
on the side wall of a vein.
Platelets in the blood stick to each other and to the
wall.
The clot gets slowly bigger and obstructs the vein,
although it is rare for the whole vein to become blocked.
Question: Why does it happen.?
Answer: Because it is a long way from the bottom of the
leg back to the heart, the calf muscle acts as a vein pump
to send the blood back up. The problem is it only works
when the muscle is working, so if you are sitting in a
chair or lying for a long time the calf muscle takes time
out.
Question: Why does that cause a clot.?
Answer: The blood is thicker, both because of dehydration
and because it is not moving about, and as a result there
is a tendency for it to become sluggish and clot.
When you eventually stand up, the muscle gets going and
the clot or a bit of it may break off and head up towards
the heart along with a tail of debris which has built up
behind and may be several inches long. It arrives in the
right side of the heart and is pumped into the lungs,
becoming a pulmonary embolism. If it is big enough to clog
up vessel it can have a big impact on breathing. The whole
functioning of the lung can be compromised.
Question: Who is at risk?.
Answer: Factors include being over 40, although there have
been younger victims. Others include being on the Pill,
smoking, overweight or having a previous DVT or recent
major surgery.
Also more susceptible are those suffering from the gene
mutation known as Factor V Leidan, found in one in twenty
of the population. It affects the clotting performance
of the blood, increasing sevenfold the sufferers
vulnerability to flight related DVT.
Few are unaware that they suffer from the mutation and
while it can be picked up in tests they are too expensive
to allow for mass screening. It is also believed that
passengers are at risk of DVT if they become dehydrated
through drinking alcohol and if they use sleeping pills.
The deep sleep induced by some knock-out drugs leads to
a long period of inactivity and lowers oxygen in the blood,
increasing stickiness.
DVT can also occur during pregnancy, because there is an
increased tendency for the blood to form clots, a natural
mechanism to prevent bleeding during childbirth.
Question: What are the symptoms?.
Answer: Early signs are swelling of the ankle. But remember
that many people get swollen ankles during flight.
However an indication that it might be DVT is when one
ankle swells much more than the other.
There may also be localised redness and some pain. More
serious symptoms are a cough, breathlessness, a rapid
heartbeat, and palpitations.
Question: What should you do?.
Answer: Seek medical advice quickly.
Question: How Serious is it?.
Answer: A pulmonary embolism can be life-threatening and
needs immediate medical attention. If it blocks a major
artery feeding the lung it can cause death from respiratory
or cardiac failure because the heart cannot get the blood
through the system.
Question: Is it always fatal?.
Answer: No. Many people get DVT and never realise it. The
clot can just sit there and not turn into an embolism. It
can be a smaller clot which goes into the lung and causes
respiratory problems but not catastrophic failure.
Or sometimes a pulmonary embolism can go unnoticed by the
victim because it is not a major part of the lung which
becomes clogged up.
Sometimes the clot does not break off at all and simply
remains as a deep vein thrombosis.
Do's and Don'ts
DO: Always have a glass of water in front of you. Make
sure drink plenty of water (or juice) both during and
before the flight. Carbonated (Seltzer) Ginger drinks
are particularly beneficial.
DO: Get up and walk up and down the aisle when you get
a chance.
DO: Take an aspirin before the flight to thin the blood.
But check with your GP, aspirin is not advisable with
conditions such as stomach ulcers.
DO: Try elastic stoking, particularly if you have varicose
veins. They apply constant pressure down the leg and aid
the blood flow.
DON'T: Drink alcohol, it dehydrates you.
DON'T: Drink too much coffee or tea; like alcohol they
can dehydrate you.
DON'T: Have any kind of obstruction near or around the
calves when seated.
DON'T: Go to sleep with any constriction on lower legs.
DON'T: Wear tight socks, though you can wear the airline
versions which are not constricting.
DON'T: Smoke. even assuming the airline allows it.
NEW DRUG
A new generation drug has been launched which can
dramatically reduce the serious risk of potentially fatal blood
clots following orthopaedic surgery.
Deep vein thrombosis - blood clots in the legs - caused by
"economy class syndrome" on long-haul flights has
attracted much publicity.
But a much bigger cause of clots both in the legs and the
lungs is orthopaedic operations such as hip replacement,
repair of hip fractures and major knee surgery.
With no preventative treatment, an estimated 50% of the
180,000 UK patients undergoing surgery to lower limbs
each year will develop deep vein thrombosis.
DVT often occurs without the patient or doctors knowing,
and may lead to a blood clot in the lung, or pulmonary
embolism, which can be fatal.
Current treatments reduce the hazard, but a 15% to 30%
risk remains that a patient will develop either DVT or PE.
In 2000-2001 there were in excess of 45,000 NHS hospital
admissions resulting from DVT or PE, of which more than
80% were emergencies.
The new drug, fondaparinux sodium, sold under the brand
name Arixtra, is said to reduce the risk by a further 50% - a
massive improvement.
John Skinner, consultant orthopaedic surgeon at the Royal
National Orthopaedic Hospital in Stanmore, Middlesex,
said: "There remains a need for an effective, well-tolerated
agent that will help to prevent venous thromboembolism
(blood clots). Such a therapy could save lives and reduce
the pressure on the NHS when it has to cope with this
dangerous yet difficult to diagnose condition."
Arixtra is the first of a new class of drug which targets a
particular protein called activated factor X that plays a key
role in clotting blood. Trials have shown it to be more than
50% more effective than the currently most widely
prescribed anti-clotting agent, enoxaparin. Unlike
enoxaparin, however, Arixtra does not affect the blood
platelets which help prevent bleeding.
2 July 2002
Exposure to infrasound generated by jet engines proposed as
essential cause of Airline Passenger’s DVT Syndrome -and of
Temporal Lobe Atrophy in airline hostesses.
Size of the problem.
According to www.aviation-health.org of the 54 million
passengers carried by European airlines on longhaul trips
for an average of 9.4 hours, one million passengers suffer
from air-related DVT, or around 5%. On short haul trips of
3 to 4 hours it is 1 to 2%.
The UK lobby group ‘Victims of Air-Related DVT Association’
(VARDA) is linked to this website.
www.airhealth.org has collated 21 medical reports leading
to a conservative estimate of one million airline passengers
diagnosed and treated in the USA each year, with 100,000
fatalities. Combining the European and US figures, we may
have greatly in excess of these last numbers per annum.
In a recent trial, Scurr et al (2001) showed that around
10% of long haul (median 24 hours) passengers older than
50 but without other known risk factors developed ‘symptomless’
DVT after one return flight, returning to the UK within
6 weeks. This appears to be a significant finding
(the general population is more at risk) which has not yet
impacted on the mind of the travelling public. These smaller
blood clots are capable of moving to the lungs, sometimes
with fatal results. However, in this trial all positive cases
were treated with heparin and referred to their GP’s.
There are two Class Actions in progress, one involving Collins
Solicitors working with VARDA in the UK on a A$55 million case
against several airlines, alleging that the airlines did not
warn passengers of the risks of developing DVT; the other
Slater & Gordon in Australia suing Qantas, BA, KLM and the
Australian air safety body CASA on the same basis as at
July 2001.
The website
www.flyana.com provides professional insight into
how airline passenger health has been compromised by commercial
or economic considerations in recent years.
Another website..
http://www.vascularsociety.org.uk/pa...vt_travel.html
Complete report free by email from: "David Collier"
Acknowledgements: Daily Mail, Ananova, Dave Collier and Joe Curry
--
www.edinburghairport.org.uk
Scotland's most convenient/accessible airport.
https://www.germanwings.com/images/f...ted_image_map_...
http://www.yabbers.com/phpbb/?mforum=edinburghairpor
Who loves ya.
Tom
Jesus Was A Vegetarian!
http://tinyurl.com/634q5a
Man Is A Herbivore!
http://tinyurl.com/4rq595
DEAD PEOPLE WALKING
http://tinyurl.com/zk9fk
Would this BE because of their PREdisposal to too many red blood
cells / polycythemia ?
Lung disease is accompanied by erythrocytosis / polycythemia /
increased red blood cells.
The lung disease induced blood cell production is NOW increased even
more / red blood cell production / low cabin pressure .. leads to
increased chance of .. death / stroke .. ?
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Pre-Flight Testing Urged for All Travelers With Restrictive Lung
Disease
(Reuters Health) Jun 24 - All patients with severe extrapulmonary
restrictive lung disease should undergo a hypoxic challenge test
prior
to air travel, according to a report in the June issue of Thorax.
The authors of the paper, led by Dr. M. W. Elliott from St. James's
University Hospital, Leeds, UK, note that according to British
Thoracic Society guidelines, travelers with respiratory disease do
not
need to be assessed for a need for supplemental in-flight oxygen if
their resting oxygen saturation is greater than 95%. These
guidelines,
the authors say, are based "on anecdotal evidence and little data."
To assess the appropriateness of the British guidelines, the
researchers administered hypoxic challenge tests to 19 adults with
kyphoscoliosis or neuromuscular disease, all of whom were at risk for
nocturnal hypoventilation and 15 of whom used home ventilators while
sleeping.
All subjects completed the challenge with no adverse effects,
although
testing was aborted in 5 patients when oxygen saturation fell below
85%. Three of these 5 had resting oxygen saturation levels above 95%.
Based on the results of the hypoxic challenge tests, supplemental in-
flight oxygen would be recommended for 50% of the patients with
resting oxygen saturation above 95% (who would not be deemed by the
British Thoracic Society guidelines to require in-flight oxygen) and
71% of patients with borderline baseline oxygen saturation (92-95%).
Only 4 of the 19 patients in this study would definitely not require
in-flight oxygen based on the test result, the researchers note.
There was no consistent relationship between the change in partial
pressure of arterial oxygen (PaO2) and the change in partial pressure
of arterial carbon dioxide (PaCO2) during hypoxic challenge, the
investigators say.
"This finding suggests that all patients with severe extrapulmonary
restrictive lung disease should undergo assessment with hypoxic
challenge test prior to air travel," the authors conclude. "The study
confirms that even patients with a resting saturation of 95% can
desaturate significantly during hypoxic challenge."
"A decision as to whether it is safe for a patient to fly should be
made by an experienced clinician...based on a number of factors,
which
should include previous travel experience, the patient's overall
condition, and the results of a hypoxic challenge test," they add.
Thorax 2009;64:532-534.
--------------
Who loves ya.
Tom
Jesus Was A Vegetarian!http://tinyurl.com/2r2nkh
Man Is A Herbivore!http://tinyurl.com/4rq595
DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk