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Franchini M, Focosi D, Pezzo MP, Mannucci PM. How we manage a high D-dimer. Haematologica 2024; 109:1035-1045. [PMID: 37881856 PMCID: PMC10985443 DOI: 10.3324/haematol.2023.283966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/18/2023] [Indexed: 10/27/2023] Open
Abstract
D-dimer, a soluble fibrin degradation product that originates from plasmin-induced degradation of cross-linked fibrin, is an important biomarker of coagulation activation and secondary fibrinolysis that is routinely used to rule out venous thromboembolism (VTE), and to evaluate the risk of VTE recurrence, as well as the optimal duration of anticoagulant therapy. Besides VTE, D-dimer may be high due to physiologic conditions, including aging, pregnancy, and strenuous physical activity. In addition, several disorders have been associated with increased D-dimer levels, ranging from disseminated intravascular coagulation to infectious diseases and cancers. Thus, it is far from unusual for hematologists to have to deal with ambulatory individuals with increased D-dimer without signs or symptoms of thrombus formation. This narrative review is dedicated to the management of these cases by the hematologist.
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Affiliation(s)
- Massimo Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
| | - Daniele Focosi
- North-Western Tuscany Blood Bank, Pisa University Hospital, Italy
| | | | - Pier Mannuccio Mannucci
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico and University of Milan, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy.
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2
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Mihaileanu FV, Popa SL, Grad S, Dumitrascu DI, Ismaiel A, Rus E, Brata VD, Padureanu AM, Dita MO, Turtoi DC, Duse TA, Badulescu AV, Bottalico P, Chiarioni G, Pop C, Mogosan C, Barsan M, Gherman CD, Stancu B, David L. The Efficiency of Serum Biomarkers in Predicting the Clinical Outcome of Patients with Mesenteric Ischemia during Follow-Up: A Systematic Review. Diagnostics (Basel) 2024; 14:670. [PMID: 38611583 PMCID: PMC11011801 DOI: 10.3390/diagnostics14070670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
The initial clinical manifestation of acute mesenteric ischemia poses a diagnostic challenge, often leading to delays in identification and subsequent surgical intervention, contributing to adverse outcomes. Serum biomarkers, offering insights into the underlying pathophysiology, hold promise as prognostic indicators for acute mesenteric ischemia. This systematic review comprehensively explores the role of blood biomarkers in predicting clinical outcomes during follow-up for patients with mesenteric ischemia. A thorough literature search across the PubMed, Cochrane Library, and EMBASE databases yielded 33 relevant publications investigating the efficacy of serum biomarkers in predicting outcomes for mesenteric ischemia. Numerous studies underscore the utility of blood biomarkers in swiftly and accurately differentiating between causes of mesenteric ischemia, facilitating a prompt diagnosis. Elevated levels of specific biomarkers, particularly D-dimers, consistently correlate with heightened mortality risk and poorer clinical outcomes. While certain serum indicators exhibit substantial potential in associating with mesenteric ischemia, further research through rigorous human trials is imperative to enhance their consistent predictive ability during the follow-up period. This study underscores the diagnostic and prognostic significance of specific biomarkers for mesenteric ischemia, emphasizing the necessity for standardized procedures in future investigations.
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Affiliation(s)
- Florin Vasile Mihaileanu
- Department of Surgery, County Hospital, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (F.V.M.); (B.S.)
| | - Stefan Lucian Popa
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Simona Grad
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Dinu Iuliu Dumitrascu
- Department of Anatomy, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Abdulrahman Ismaiel
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
| | - Eliza Rus
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Vlad Dumitru Brata
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Alexandru Marius Padureanu
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Miruna Oana Dita
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Daria Claudia Turtoi
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Traian Adrian Duse
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Andrei Vlad Badulescu
- Faculty of Medicine, ”Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (E.R.); (V.D.B.); (A.M.P.); (M.O.D.); (D.C.T.); (T.A.D.); (A.V.B.)
| | - Paolo Bottalico
- Department of Medical Sciences, University of Turin, 10126 Turin, Italy;
| | - Giuseppe Chiarioni
- Division of Gastroenterology B, AOUI Verona, University of Verona, 37126 Verona, Italy;
| | - Cristina Pop
- Department of Pharmacology, Physiology, and Pathophysiology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (C.P.); (C.M.)
| | - Cristina Mogosan
- Department of Pharmacology, Physiology, and Pathophysiology, Faculty of Pharmacy, Iuliu Hatieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania; (C.P.); (C.M.)
| | - Maria Barsan
- Department of Occupational Health, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania;
| | - Claudia Diana Gherman
- Department of Surgery-Practical Abilities, “Iuliu Hațieganu” University of Medicine and Pharmacy Cluj-Napoca, 400337 Cluj-Napoca, Romania;
| | - Bogdan Stancu
- Department of Surgery, County Hospital, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400139 Cluj-Napoca, Romania; (F.V.M.); (B.S.)
| | - Liliana David
- 2nd Medical Department, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400000 Cluj-Napoca, Romania; (S.G.); (A.I.); (L.D.)
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3
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Cai X, Li Y, Gao F, Muhammad B, Yang H. Therapeutic effect and study of human umbilical cord blood mononuclear cells in patients with ischaemic bowel disease. Sci Rep 2024; 14:6121. [PMID: 38480861 PMCID: PMC10937724 DOI: 10.1038/s41598-024-56720-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 03/10/2024] [Indexed: 03/17/2024] Open
Abstract
Ischaemic bowel disease (ICBD) is a group of intestinal ischaemia syndromes caused by various aetiologies of reduced intestinal blood flow or vascular occlusion. ICBD can present as abdominal pain, bloody stool, and diarrhoea. This disease often occurs in middle-aged and elderly individuals with cardiovascular and cerebrovascular diseases. The incidence of ischaemic bowel disease has been increasing for decades, and it is difficult to diagnose, resulting in rapid disease progression and a high mortality rate. Therefore, fully understanding this disease, improving the diagnosis rate of this disease, and finding appropriate treatment methods are urgently needed to improve the condition and prognosis of patients. Umbilical cord blood stem cells are accessible, have weak immunogenicity, and have various biological functions, such as angiogenesis, inflammation and immune regulation. Many studies have confirmed that cord blood stem cells can relieve ischaemia, and these cells have attracted tremendous amounts of attention in regenerative medicine in recent years. In this paper, we discuss the clinical characteristics of ICBD, analyse the characteristics of human umbilical cord blood mononuclear cells (HUCB-MNCs), and use its to treat ischaemic bowel disease. Additionally, we compare the clinical manifestations and related indicators before and after treatment to evaluate the efficacy and safety of these methods.
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Affiliation(s)
- Xiaoxiao Cai
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238 Jingshi East Road, Jinan, Shandong, China
- Graduate Department of Shandong First Medical University & Shandong Academy of Medical Sciences, No. 6699 Qingdao Road, Jinan, Shandong, China
| | - Yonghao Li
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238 Jingshi East Road, Jinan, Shandong, China
- Graduate Department of Shandong First Medical University & Shandong Academy of Medical Sciences, No. 6699 Qingdao Road, Jinan, Shandong, China
| | - Fengyu Gao
- Shandong Provincial Maternal and Child Health Care Hospital Affiliated to Qingdao University, No. 238 Jingshi East Road, Jinan, Shandong, China
| | - Bilal Muhammad
- Graduate Department of Shandong First Medical University & Shandong Academy of Medical Sciences, No. 6699 Qingdao Road, Jinan, Shandong, China
- Department of General Surgery, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China
| | - Hongli Yang
- Department of Gastroenterology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, No. 16766 Jingshi Road, Jinan, Shandong, China.
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Zhang W, Zhou B, Yang X, Zhao J, Hu J, Ding Y, Zhan S, Yang Y, Chen J, Zhang F, Zhao B, Deng F, Lin Z, Sun Q, Zhang F, Yao Z, Liu W, Li C, Liu KX. Exosomal circEZH2_005, an intestinal injury biomarker, alleviates intestinal ischemia/reperfusion injury by mediating Gprc5a signaling. Nat Commun 2023; 14:5437. [PMID: 37673874 PMCID: PMC10482849 DOI: 10.1038/s41467-023-41147-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
Intestinal ischemia/reperfusion (I/R) injury is a severe clinical condition without optimal diagnostic markers nor clear molecular etiological insights. Plasma exosomal circular RNAs (circRNAs) are valuable biomarkers and therapeutic targets for various diseases, but their role in intestinal I/R injury remains unknown. Here we screen the expression profile of circRNAs in intestinal tissue exosomes collected from intestinal I/R mice and identify circEZH2_005 as a significantly downregulated exosomal circRNA. In parallel, circEZH2_005 is also reduced in the plasma of clinical cardiac surgery patients who developed postoperative intestinal I/R injury. Exosomal circEZH2_005 displays a significant diagnostic value for intestinal injury induced by I/R. Mechanistically, circEZH2_005 is highly expressed in intestinal crypt cells. CircEZH2_005 upregulation promotes the proliferation of Lgr5+ stem cells by direct interaction with hnRNPA1, and enhanced Gprc5a stability, thereby alleviating I/R-induced intestinal mucosal damage. Hence, exosomal circEZH2_005 may serve as a biomarker for intestinal I/R injury and targeting the circEZH2_005/hnRNPA1/Gprc5a axis may be a potential therapeutic strategy for intestinal I/R injury.
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Affiliation(s)
- Wenjuan Zhang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Bowei Zhou
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Xiao Yang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Jin Zhao
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Jingjuan Hu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Yuqi Ding
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Shuteng Zhan
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Yifeng Yang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Jun Chen
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Fu Zhang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Bingcheng Zhao
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Fan Deng
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Zebin Lin
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Qishun Sun
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Fangling Zhang
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Zhiwen Yao
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Weifeng Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China
| | - Cai Li
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China.
| | - Ke-Xuan Liu
- Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, 1838 Guangzhou Avenue North, Guangzhou, 510515, China.
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Wauthier L, Favresse J, Hardy M, Douxfils J, Le Gal G, Roy P, van Es N, Ay C, ten Cate H, Lecompte T, Lippi G, Mullier F. D-dimer testing: A narrative review. Adv Clin Chem 2023. [DOI: 10.1016/bs.acc.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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Alagappan A, Sahoo B. Descending Colon Perforation as a Complication of Inferior Mesenteric Artery Thrombosis-COVID-19-Associated Coagulopathy. Indian J Radiol Imaging 2022; 33:136-137. [PMID: 36855713 PMCID: PMC9968543 DOI: 10.1055/s-0042-1758199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Alamelu Alagappan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India,Address for correspondence Alamelu Alagappan Department of Radiodiagnosis, All India Institute of Medical SciencesBhubaneswar 751019, OrissaIndia
| | - Biswajit Sahoo
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India,Biswajit Sahoo, MD Department of Radiodiagnosis, All India Institute of Medical SciencesBhubaneswar 751019, OrissaIndia
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Huang HY, Lin XK, Guo SK, Bao XZ, Lin ZX, Li ZR, Huang XZ. Haemostatic indexes for predicting intestinal necrosis in children with intussusception. ANZ J Surg 2021; 91:1485-1490. [PMID: 33908173 DOI: 10.1111/ans.16854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To determine risk factors for intestinal necrosis in intussusception cases among children with failed non-surgical reduction for intussusception. METHODS Totally, 540 hospitalized individuals with unsuccessful air-enema reduction in our hospital between November 2010 and November 2020 were assessed in this retrospective study. The 540 intussusception cases were divided into the intestinal necrosis and non-intestinal necrosis groups. Haemostatic parameters, demographic and clinical features were assessed. Predictors of intestinal necrosis were examined by univariable and multivariable logistic regression analyses. RESULTS Of the 540 patients included, 113 showed intestinal necrosis. This intestinal necrosis group had a longer duration of symptom or length of illness, younger ages, higher platelet counts, fibrinogen amounts and d-dimer levels (all P = 0.000) compared with the non-intestinal necrosis group. Multivariable analysis revealed that duration of symptom (odds ratio (OR) 1.12; 95% confidence interval (CI) 1.16-1.23, P = 0.000), fibrinogen (OR 1.26; 95% CI 1.10-1.31, P = 0.010) and d-dimer (OR 2.07; 95% CI 1.91-2.28, P = 0.000) independently predicted intestinal necrosis in individuals undergoing surgical reduction for intussusception. Receiver operating characteristic curve analysis showed that d-dimer amounts had the largest area under the curve for predicting intestinal necrosis. CONCLUSION On admission, long duration of symptom, high fibrinogen and d-dimer levels are critical risk factors for intestinal necrosis development in children with unsuccessful non-surgical reduction. d-Dimer levels have the best predictive value for intestinal necrosis.
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Affiliation(s)
- Hui-Ya Huang
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Kun Lin
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Shi-Kun Guo
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Zhou Bao
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zheng-Xiu Lin
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Zhong-Rong Li
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Zhong Huang
- The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
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Wu C, Zhu X, Ren H, Tan F, Liu X. Intestinal fatty acid-binding protein as a biomarker for the diagnosis of strangulated intestinal obstruction: A meta-analysis. Open Med (Wars) 2021; 16:264-273. [PMID: 33623822 PMCID: PMC7885302 DOI: 10.1515/med-2021-0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/12/2020] [Accepted: 12/01/2020] [Indexed: 12/01/2022] Open
Abstract
Objective The purpose of this study was to clarify the value of intestinal fatty acid-binding protein (I-FABP) for the early diagnosis of strangulated intestinal obstruction through a meta-analysis. Methods A search was performed on PubMed, EBSCO, the Cochrane Library, the Web of Science, EMBASE, CNKI, and WanFang for studies on the diagnosis of strangulated intestinal obstruction based on I-FABP. Endnote X9 software and the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) were used to screen the studies and evaluate their quality, respectively. Meta-Disc 1.4 and Stata 15.1 software were used to perform the assessment of heterogeneity and meta-analysis. Result A total of eight studies were included, Spearman correlation coefficient was 0.703 (P = 0.078), suggesting that there was no threshold effect. The pooled results of the meta-analysis were as follows: sensitivity: 0.75 (95% CI: 0.66–0.81), specificity: 0.83 (95% CI: 0.71–0.91), positive likelihood ratio (PLR): 4.35 (95% CI: 2.57–7.36), negative likelihood ratio (NLR): 0.31 (95% CI: 0.24–0.39), and diagnostic odds ratio (DOR): 14.19 (95% CI: 8.08–24.92). The area under the curve was 0.83. There was obvious heterogeneity among the studies. Conclusion I-FABP is very valuable for the early diagnosis of strangulated intestinal obstruction and can be used to distinguish strangulated intestinal obstruction from intestinal obstruction in a timely manner, enabling accurate planning of the timing of surgery.
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Affiliation(s)
- Caihong Wu
- Emergency Department, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
| | - Xuehe Zhu
- Emergency Department, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
| | - Haipeng Ren
- Emergency Department, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
| | - Fuyong Tan
- The Medical Examination Center, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
| | - Xudong Liu
- Emergency Department, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia, China
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Favresse J, Lippi G, Roy PM, Chatelain B, Jacqmin H, Ten Cate H, Mullier F. D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications. Crit Rev Clin Lab Sci 2019; 55:548-577. [PMID: 30694079 DOI: 10.1080/10408363.2018.1529734] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
D-dimer is a soluble fibrin degradation product deriving from the plasmin-mediated degradation of cross-linked fibrin. D-dimer can hence be considered a biomarker of activation of coagulation and fibrinolysis, and it is routinely used for ruling out venous thromboembolism (VTE). D-dimer is increasingly used to assess the risk of VTE recurrence and to help define the optimal duration of anticoagulation treatment in patients with VTE, for diagnosing disseminated intravascular coagulation, and for screening medical patients at increased risk of VTE. This review is aimed at (1) revising the definition of D-dimer; (2) discussing preanalytical variables affecting the measurement of D-dimer; (3) reviewing and comparing assay performance and some postanalytical variables (e.g. different units and age-adjusted cutoffs); and (4) discussing the use of D-dimer measurement across different clinical settings.
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Affiliation(s)
- Julien Favresse
- a CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory , Université Catholique de Louvain , Yvoir , Belgium
| | - Giuseppe Lippi
- b Section of Clinical Biochemistry , University Hospital of Verona , Verona , Italy
| | - Pierre-Marie Roy
- c Département de Médecine d'Urgence, CHU d'Angers, Institut MITOVASC , Université d'Angers , Angers , France
| | - Bernard Chatelain
- a CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory , Université Catholique de Louvain , Yvoir , Belgium
| | - Hugues Jacqmin
- a CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory , Université Catholique de Louvain , Yvoir , Belgium
| | - Hugo Ten Cate
- d Department of Internal Medicine, Cardiovascular Institute , Maastricht University Medical Center , Maastricht , the Netherlands
| | - François Mullier
- a CHU UCL Namur, Namur Thrombosis and Hemostasis Center, Hematology Laboratory , Université Catholique de Louvain , Yvoir , Belgium
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Montagnana M, Danese E, Lippi G. Biochemical markers of acute intestinal ischemia: possibilities and limitations. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:341. [PMID: 30306080 DOI: 10.21037/atm.2018.07.22] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Acute intestinal ischemia is a relative rare abdominal emergency, associated with considerably high morbidity and mortality rates. Although the conventional diagnostic approach to acute intestinal ischemia entails a preliminary evaluation of signs and symptoms, followed by radiological and laboratory investigations, a definitive diagnosis is can usually be made after laparotomy, which still remains the gold standard diagnostic (and therapeutic) procedure. Several potential laboratory biomarkers have been investigated over the past decades, but none of these seems to reach a suitable diagnostic accuracy for an early and reliable diagnosis of intestinal ischemia. The aim of this narrative review is to provide an overview on traditional laboratory tests for diagnosing acute intestinal ischemia (i.e., complete blood count, D-dimer, blood gas analysis, total lactic acid, C-reactive protein and procalcitonin), and summarize current evidence regarding some emerging and potentially useful biomarkers such as D-lactate, intestinal fatty acid-binding protein (I-FABP), ischemia modified albumin (IMA), α-glutathione S-transferase (α-GST), interleukin-6 (IL-6), citrulline and smooth muscle protein of 22 kDa (SM22). Among the various tests, D-lactate, IMA and I-FABP are perhaps the most promising, since they are characterized by optimal sensitivity and relatively good specificity, early kinetics, and can be measured with assays suited for a rapid diagnosis.
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Affiliation(s)
- Martina Montagnana
- Clinical Biochemistry Section, University Hospital of Verona, Verona, Italy
| | - Elisa Danese
- Clinical Biochemistry Section, University Hospital of Verona, Verona, Italy
| | - Giuseppe Lippi
- Clinical Biochemistry Section, University Hospital of Verona, Verona, Italy
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Dong L, Dong G, Cao J, Zhang J. Association of α2-HS Glycoprotein with Neurogenic Heterotopic Ossification in Patients with Spinal Cord Injury. Med Sci Monit 2017; 23:5382-5388. [PMID: 29128864 PMCID: PMC5699169 DOI: 10.12659/msm.904626] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background The aim of this study was to explore the relationship between the α2-HS glycoprotein concentrations in serum and the occurrence of neurogenic heterotopic ossification (NHO) in patients with spinal cord injury (SCI). Material/Methods During the period between January 2011 and January 2012, 75 patients (67 male) with paraplegia caused by spinal cord injury were enrolled. The patients were divided into 2 groups in accordance with the occurrence of heterotopic ossification based on the results high-frequency ultrasound on the bilateral hip joint. The levels of α2-HS glycoprotein, C-reactive protein (CRP), D-dimer, and bone morphogenetic protein (BMP) were detected by ELISA. Results We found a significant decrease of α2-HS glycoprotein in SCI patients with NHO compared to SCI patients without NHO. In contrast, a significant elevation of serum calcium, D-dimer, BMP, and CRP was observed in SCI patients with NHO. The degree of maturity of NHO did not influence the level of α2-HS glycoprotein. Multivariate liner regression analysis showed that the level of serum α2-HS glycoprotein was correlated with CRP and spasticity. Conclusions The decreased level of α2-HS glycoprotein may be related to the formation of neurogenic heterotopic ossification in patients with spinal cord injury. Our results suggest that α2-HS glycoprotein might be a risk factor for NHO in patients with SCI.
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Affiliation(s)
- Liwei Dong
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Guodong Dong
- Station Hospital, The People's Army Troop 93523, Shijiazhuang, Hebei, China (mainland)
| | - Jianye Cao
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
| | - Jing Zhang
- Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (mainland)
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Peoc’h K, Nuzzo A, Guedj K, Paugam C, Corcos O. Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far. ACTA ACUST UNITED AC 2017; 56:373-385. [DOI: 10.1515/cclm-2017-0291] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 07/21/2017] [Indexed: 12/20/2022]
Abstract
Abstract
Acute intestinal ischemic injury (i3) is a life-threatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3. Apart from non-specific biological markers of thrombosis, hypoxia inflammation, and infection, several more specific biomarkers in relation with the gut barrier dysfunction, the villi injury and the enterocyte mass have been used in the diagnosis of acute i3. It includes particularly D-lactate, intestinal fatty acid-binding protein (FABP) and citrulline. Herein, we will discuss leading publications concerning these historical markers that point out the main limitations reagrding their use in routine clinical practice. We will also introduce the first and limited results arising from omic studies, underlying the remaining effort that needs to be done in the field of acute i3 biological diagnosis, which remains a challenge.
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Affiliation(s)
- Katell Peoc’h
- Biochimie Clinique, Hôpital Beaujon , Université Paris Diderot, UFR de Médecine Xavier Bichat and APHP, HUPNVS, DHU Unity , Clichy , France
- INSERM, UMRs 1149, CRI , Université Paris Diderot , Paris , France , Phone: +33 (0)1 40 87 54 36
| | - Alexandre Nuzzo
- SURVI, Hôpital Beaujon, APHP, HUPNVS, DHU Unity , Clichy , France
- Gastroenterologie, Hôpital Beaujon, APHP, HUPNVS , Clichy , France
| | - Kevin Guedj
- SURVI, Hôpital Beaujon, APHP, HUPNVS, DHU Unity , Clichy , France
- INSERM, UMRs 1148, LVTS , Paris , France
| | - Catherine Paugam
- Anesthésie Réanimation, Hôpital Beaujon , Université Paris Diderot, UFR de Médecine Xavier Bichat and APHP, HUPNVS , Clichy , France
| | - Olivier Corcos
- SURVI, Hôpital Beaujon, APHP, HUPNVS, DHU Unity , Clichy , France
- Gastroenterologie, Hôpital Beaujon, APHP, HUPNVS , Clichy , France
- INSERM, UMRs 1148, LVTS , Paris , France
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