1
|
Prochaska J, Arnold N, Falcke A, Kopp S, Schulz A, Buch G, Moll S, Panova-Noeva M, Jünger C, Eggebrecht L, Pfeiffer N, Beutel M, Binder H, Grabbe S, Lackner K, Ten Cate-Hoek A, Espinola-Klein C, Münzel T, Wild P. Chronic Venous Insufficiency, Cardiovascular Disease, and Mortality: A Population Study. J Vasc Surg Venous Lymphat Disord 2022. [DOI: 10.1016/j.jvsv.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
2
|
Rothermel A, Kaim H, Gambach S, Schuetz H, Moll S, Steinhoff R, Herrmann T, Zeck G. Subretinal Stimulation Chip Set with 3025 Electrodes, Spatial Peaking Filter, Illumination Adaptation and Implant Lifetime Optimization. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:4310-4313. [PMID: 33018949 DOI: 10.1109/embc44109.2020.9175722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A subretinal stimulator chip has been designed and tested, which combines high pixel number with highest simulation voltages, lowest power consumption, spatial peaking and illumination adaptation. A supporting ASIC completes the implantable device electronics. Blind mouse retina has successfully been stimulated in vitro.
Collapse
|
3
|
Berchtold L, Crowe L, Friedli I, Moll S, De Perrot T, Martin P, Vallée J, De Seigneux S. L’IRM de diffusion permet de détecter une augmentation de la fibrose intersitielle avant la baisse de la fonction rénale. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
4
|
Gillmann K, Moll S, Zellweger M, Bourquin V, Baglivo E. [Ophthalmological presentation of hypertensive crisis in the context of Berger's disease: Recommendation for a multidisciplinary follow-up of IgA nephropathies]. J Fr Ophtalmol 2018; 41:e137-e139. [PMID: 29656828 DOI: 10.1016/j.jfo.2017.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 08/31/2017] [Accepted: 09/01/2017] [Indexed: 11/16/2022]
Affiliation(s)
- K Gillmann
- Ophthalmologic Network Organisation, 15, avenue Bois-de-la-Chapelle, 1213 Onex, Genève, Suisse.
| | - S Moll
- Hopitaux universitaires de Genève, 1205 Genève, Suisse
| | - M Zellweger
- Groupe médical d'Onex, 3, route de Loëx, 1213 Onex, Genève, Suisse
| | - V Bourquin
- Hopitaux universitaires de Genève, 1205 Genève, Suisse
| | - E Baglivo
- Ophthalmologic Network Organisation, 15, avenue Bois-de-la-Chapelle, 1213 Onex, Genève, Suisse
| |
Collapse
|
5
|
Moll S, De Moerloose P, Reber G, Schifferli J, Leski M. Comparison of Two Hemodialysis Membranes, Polyacrilonitrile and Cellulose Acetate, on Complement and Coagulation Systems. Int J Artif Organs 2018. [DOI: 10.1177/039139889001300503] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Two hemodialysis membranes, polyacrilonitrile (AN 69) and cellulose acetate (CA), were compared for their effects on complement and hemostasis. Two groups of 5 patients, in dialysis for more than 5 years, were successively dialysed for 4 weeks periods with each type of membrane. We measured C3a (complement activation), platelets and beta-thromboglobulin (platelet activation), thrombin-antithrombin III complexes and fibrinopeptide A (coagulation activation), using C-Reactive Protein as a control for dilution effects. As previously shown, activation of complement was more important with CA than with AN 69 (p < 0.01). In contrast, activation of coagulation (increase in fibrinopeptide A and thrombin-antithrombin III complexes) was more pronounced with AN 69 than with CA. This study emphasizes the need to consider different biological systems when the bioincompatibility of a hemodialysis membrane is evaluated
Collapse
Affiliation(s)
- S. Moll
- Division of Nephrology and Hemostasis Unit, Department of Medicine, University Cantonal Hospital, Geneva - Switzerland
| | - P. De Moerloose
- Division of Nephrology and Hemostasis Unit, Department of Medicine, University Cantonal Hospital, Geneva - Switzerland
| | - G. Reber
- Division of Nephrology and Hemostasis Unit, Department of Medicine, University Cantonal Hospital, Geneva - Switzerland
| | - J. Schifferli
- Division of Nephrology and Hemostasis Unit, Department of Medicine, University Cantonal Hospital, Geneva - Switzerland
| | - M. Leski
- Division of Nephrology and Hemostasis Unit, Department of Medicine, University Cantonal Hospital, Geneva - Switzerland
| |
Collapse
|
6
|
Meier RPH, Piller V, Hagen ME, Joliat C, Buchs J, Nastasi A, Ruttimann R, Buchs NC, Moll S, Vallée J, Lazeyras F, Morel P, Bühler L. Intra-Abdominal Cooling System Limits Ischemia-Reperfusion Injury During Robot-Assisted Renal Transplantation. Am J Transplant 2018; 18:53-62. [PMID: 28637093 PMCID: PMC5763420 DOI: 10.1111/ajt.14399] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 06/04/2017] [Accepted: 06/14/2017] [Indexed: 01/25/2023]
Abstract
Robot-assisted kidney transplantation is feasible; however, concerns have been raised about possible increases in warm ischemia times. We describe a novel intra-abdominal cooling system to continuously cool the kidney during the procedure. Porcine kidneys were procured by standard open technique. Groups were as follows: Robotic renal transplantation with (n = 11) and without (n = 6) continuous intra-abdominal cooling and conventional open technique with intermittent 4°C saline cooling (n = 6). Renal cortex temperature, magnetic resonance imaging, and histology were analyzed. Robotic renal transplantation required a longer anastomosis time, either with or without the cooling system, compared to the open approach (70.4 ± 17.7 min and 74.0 ± 21.5 min vs. 48.7 ± 11.2 min, p-values < 0.05). The temperature was lower in the robotic group with cooling system compared to the open approach group (6.5 ± 3.1°C vs. 22.5 ± 6.5°C; p = 0.001) or compared to the robotic group without the cooling system (28.7 ± 3.3°C; p < 0.001). Magnetic resonance imaging parenchymal heterogeneities and histologic ischemia-reperfusion lesions were more severe in the robotic group without cooling than in the cooled (open and robotic) groups. Robot-assisted kidney transplantation prolongs the warm ischemia time of the donor kidney. We developed a novel intra-abdominal cooling system that suppresses the noncontrolled rewarming of donor kidneys during the transplant procedure and prevents ischemia-reperfusion injuries.
Collapse
Affiliation(s)
- R. P. H. Meier
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - V. Piller
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - M. E. Hagen
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - C. Joliat
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - J.‐B. Buchs
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - A. Nastasi
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - R. Ruttimann
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - N. C. Buchs
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - S. Moll
- Division of Clinical PathologyDepartment of Pathology and ImmunologyGeneva University Hospital and Medical SchoolGenevaSwitzerland
| | - J.‐P. Vallée
- Department of Radiology and Medical InformaticsFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - F. Lazeyras
- Department of Radiology and Medical InformaticsFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - P. Morel
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| | - L. Bühler
- Visceral and Transplant SurgeryDepartment of SurgeryGeneva University Hospitals and Medical SchoolGenevaSwitzerland
| |
Collapse
|
7
|
Abstract
Essentials Athletes on anticoagulants are typically prohibited from participation in contact sports. Short-acting anticoagulants allow for reconsideration of this precedent. An individualized pharmacokinetic/pharmacodynamics study can aid patient-specific management. Many challenges and unresolved issues exist regarding such tailored intermittent dosing. SUMMARY Athletes with venous thromboembolism (VTE) are typically prohibited from participating in contact sports during anticoagulation therapy, but such mandatory removal from competition can cause psychological and financial detriments for athletes and overlooks patient autonomy. The precedent of compulsory removal developed when options for anticoagulation therapy were more limited, but medical advances now allow for rethinking of the management of athletes with VTE. We propose a novel therapeutic approach to the treatment of athletes who participate in contact sports and require anticoagulation. A personalized pharmacokinetic/pharmacodynamics study of a direct oral anticoagulant can be performed for an athlete, which can inform the timing of medication dosing. Managed carefully, this can allow athletic participation when plasma drug concentration is minimal (minimizing bleeding risk) and prompt resumption of treatment after the risk of bleeding sufficiently normalizes (maximizing therapeutic time).
Collapse
Affiliation(s)
- J N Berkowitz
- Departments of Orthopaedics and Sports Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - S Moll
- Department of Medicine, Division of Hematology-Oncology, Hemophilia and Thrombosis Center, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| |
Collapse
|
8
|
Mantha S, Moll S, Hilden P, Devlin S, Rose A. The patterns of anticoagulation control and the risk of stroke, bleeding and mortality in patients with non-valvular atrial fibrillation: comment. J Thromb Haemost 2016; 14:2083-2084. [PMID: 27431450 DOI: 10.1111/jth.13420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Indexed: 12/01/2022]
Affiliation(s)
- S Mantha
- Hematology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - S Moll
- Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - P Hilden
- Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - S Devlin
- Epidemiology-Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - A Rose
- Medicine, Boston University School of Medicine, Boston, MA, USA
| |
Collapse
|
9
|
Kearon C, Parpia S, Spencer F, Baglin T, Stevens S, Bauer K, Lentz S, Kessler C, Douketis J, Moll S, Kaatz S, Schulman S, Connors J, Ginsberg J, Spadafora L, Liaw P, Weitz J, Julian J. D-dimer levels and recurrence in patients with unprovoked VTE and a negative qualitative D-dimer test after treatment. Thromb Res 2016; 146:119-125. [DOI: 10.1016/j.thromres.2016.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 11/28/2022]
|
10
|
Friedli I, Crowe LA, Berchtold L, Moll S, Hadaya K, de Perrot T, Vesin C, Martin PY, de Seigneux S, Vallée JP. New Magnetic Resonance Imaging Index for Renal Fibrosis Assessment: A Comparison between Diffusion-Weighted Imaging and T1 Mapping with Histological Validation. Sci Rep 2016; 6:30088. [PMID: 27439482 PMCID: PMC4954968 DOI: 10.1038/srep30088] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/29/2016] [Indexed: 12/12/2022] Open
Abstract
A need exists to noninvasively assess renal interstitial fibrosis, a common process
to all kidney diseases and predictive of renal prognosis. In this translational
study, Magnetic Resonance Imaging (MRI) T1 mapping and a new segmented
Diffusion-Weighted Imaging (DWI) technique, for Apparent Diffusion Coefficient
(ADC), were first compared to renal fibrosis in two well-controlled animal models to
assess detection limits. Validation against biopsy was then performed in 33 kidney
allograft recipients (KARs). Predictive MRI indices, ΔT1 and
ΔADC (defined as the cortico-medullary differences), were compared to
histology. In rats, both T1 and ADC correlated well with fibrosis and inflammation
showing a difference between normal and diseased kidneys. In KARs, MRI indices were
not sensitive to interstitial inflammation. By contrast, ΔADC
outperformed ΔT1 with a stronger negative correlation to fibrosis
(R2 = 0.64 against
R2 = 0.29
p < 0.001). ΔADC tends to negative values
in KARs harboring cortical fibrosis of more than 40%. Using a discriminant analysis
method, the ΔADC, as a marker to detect such level of fibrosis or
higher, led to a specificity and sensitivity of 100% and 71%, respectively. This new
index has potential for noninvasive assessment of fibrosis in the clinical
setting.
Collapse
Affiliation(s)
- I Friedli
- Division of Radiology, Department of Radiology and Medical Informatics Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - L A Crowe
- Division of Radiology, Department of Radiology and Medical Informatics Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - L Berchtold
- Service of Nephrology, Department of Internal Medicine Specialties, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - S Moll
- Division of Pathology, Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - K Hadaya
- Divisions of Nephrology and Transplantation, Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - T de Perrot
- Division of Radiology, Department of Radiology and Medical Informatics Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - C Vesin
- Division of Cell Physiology and Metabolism, Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| | - P-Y Martin
- Service of Nephrology, Department of Internal Medicine Specialties, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - S de Seigneux
- Service of Nephrology, Department of Internal Medicine Specialties, Geneva University Hospitals, University of Geneva, Faculty of Medicine, Geneva, Switzerland
| | - J-P Vallée
- Division of Radiology, Department of Radiology and Medical Informatics Geneva University Hospitals and Faculty of Medicine of the University of Geneva, Switzerland
| |
Collapse
|
11
|
Martin K, Beyer-Westendorf J, Davidson BL, Huisman MV, Sandset PM, Moll S. Use of the direct oral anticoagulants in obese patients: guidance from the SSC of the ISTH. J Thromb Haemost 2016; 14:1308-13. [PMID: 27299806 PMCID: PMC4936273 DOI: 10.1111/jth.13323] [Citation(s) in RCA: 318] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/03/2016] [Indexed: 12/16/2022]
Affiliation(s)
- K Martin
- Department of Medicine, Division of Hematology-Oncology, University of North Carolina, Chapel Hill, NC, USA
| | - J Beyer-Westendorf
- Thrombosis Research Unit, Center for Vascular Diseases, University Hospital, Technische Universität Dresden, Dresden, Germany
| | - B L Davidson
- Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - M V Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - P M Sandset
- Department of Hematology, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - S Moll
- Department of Medicine, Division of Hematology-Oncology, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
12
|
Letertre LR, Gudmundsdottir BR, Francis CW, Gosselin RC, Skeppholm M, Malmstrom RE, Moll S, Hawes E, Francart S, Onundarson PT. A single test to assay warfarin, dabigatran, rivaroxaban, apixaban, unfractionated heparin, and enoxaparin in plasma. J Thromb Haemost 2016; 14:1043-53. [PMID: 26924677 DOI: 10.1111/jth.13300] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 02/04/2016] [Indexed: 11/28/2022]
Abstract
UNLABELLED Essentials Simple and fast assaying of different anticoagulants (ACs) is useful in emergent situations. We used highly diluted prothrombin time (dPT) or highly diluted Fiix-PT (dFiix-PT) to assay ACs. Both tests could quantify target specific anticoagulants and warfarin anticoagulation. Improved results were consistently observed with the dFiix-PT compared with the dPT. SUMMARY Background Assaying anticoagulants is useful in emergency situations or before surgery. Different specific assays are currently needed depending on the anticoagulant. Objectives We hypothesized that levels of warfarin, dabigatran, rivaroxaban, apixaban, and heparins could be measured with use of the diluted prothrombin time (dPT) and diluted Fiix-PT (dFiix-PT), using highly diluted thromboplastin (TP). The latter test is affected only by reduced levels of active factors II and X but corrects test plasma for other deficiencies Methods Increasing TP dilutions were used to identify suitable dilutions to measure dabigatran, rivaroxaban, apixaban, unfractionated heparin (UFH), and enoxaparin. Calibrators containing known amounts of direct oral anticoagulants (DOACs) were used to make standard curves. Citrated plasma samples were obtained from patients taking warfarin or DOACs with known drug concentrations as determined by specific assays. Results The dFiix-PT at a TP dilution of 1:1156 could be used to measure all of the drugs tested at therapeutic concentrations except for fondaparinux. The dPT achieved the same but required two TP dilutions (1:750 and 1:300). The warfarin effect could be assessed by using dFiix-PT at 1:1156 with a PT ratio identical to the international normalized ratio. Six different TPs yielded similar results, but two were less sensitive. Dabigatran, rivaroxaban, and apixaban could be accurately measured in patient samples using both dilute PT assays, but a better correlation was consistently observed between the dFiix-PT and specific assays than with the dPT. Conclusion The dFiix-PT using a single dilution of TP may be suitable to assess the anticoagulant effects of warfarin, dabigatran, rivaroxaban, apixaban, heparin, and enoxaparin.
Collapse
Affiliation(s)
- L R Letertre
- Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
| | - B R Gudmundsdottir
- Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
| | - C W Francis
- University of Rochester Medical Center, Rochester, NY, USA
| | - R C Gosselin
- University of California, Davis Medical Center, Sacramento, CA, USA
| | - M Skeppholm
- Danderyd Hospital and Department of Clinical Sciences & Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - R E Malmstrom
- Clinical Pharmacology, Karolinska University Hospital & Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - S Moll
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - E Hawes
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
- University of North Carolina Department of Pharmacy, Chapel Hill, NC, USA
| | - S Francart
- University of North Carolina Department of Pharmacy, Chapel Hill, NC, USA
| | - P T Onundarson
- Landspitali The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland
| |
Collapse
|
13
|
Göhring-Zwacka E, Kömpf D, Wiesinger R, Moll S, Jäckh B, Kirch A, Frlicka M, Reick D, Körber J. Labornachweis von Chlamydia trachomatis und Neisseria gonorrhoeae für die HIV-/STI-Beratungsstellen der Gesundheitsämter in Baden-Württemberg – Projektskizze und erste Ergebnisse. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1578937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
Muji A, Moll S, Saudan P. [Oxalate nephropathy: a new entity of acute kidney injury in diabetic patients?]. Rev Med Suisse 2015; 11:493-498. [PMID: 25898457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Acute oxalate nephropathy is a severe cause of acute kidney injury characterized by tubule-interstitial oxalate deposits with an inflammatory infiltrate. Three cases of AKI occuring in diabetic patients, and whose renal biopsy gave a diagnosis of acute oxalate nephropathy are reported. This cristal deposit AKI is due to either primary hyperoxaluria or secondary to enteric hyperabsorption. Its prognosis is dismal and rapid recognition by renal biopsy and determination of the cause of hyperoxaluria is mandatory in order to avoid end-stage kidney disease. This diagnosis should be suspected in cases of non resolving AKI, especially in diabetic patients who may have undetected pancreatic exocrine insufficiency.
Collapse
|
15
|
Gosselin RC, Adcock D, Hawes EM, Francart SJ, Grant RP, Moll S. Evaluating the use of commercial drug-specific calibrators for determining PT and APTT reagent sensitivity to dabigatran and rivaroxaban. Thromb Haemost 2014; 113:77-84. [PMID: 25413383 DOI: 10.1160/th14-04-0361] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/22/2014] [Indexed: 11/05/2022]
Abstract
Suitable laboratory methodologies for quantifying the non-vitamin K oral anticoagulants (NOAC) include liquid chromatography-tandem mass spectrometry (LC-MS/MS) or drug-calibrated assays such as the dilute thrombin time for dabigatran or anti-Xa measurements for rivaroxaban. In situations when these tests are unavailable, it has been suggested that using commercial drug calibrators on APTT and PT assays would theoretically provide reagent sensitivity to these drugs. The purpose of this study was to determine whether commercial drug calibrators deliver similar reagent sensitivity information as samples from patients receiving dabigatran or rivaroxaban as part of their routine care. Two laboratory sites tested commercial calibrator material for dabigatran and rivaroxaban (Hyphen Biomedical) using PT and APTT reagents and data was compared to samples collected from patients taking NOACs that were quantified by LC-MS/MS. Correlation statistics and calculating the amount of drug required to double the clotting time of normal plasma were performed. All drug calibrator material correlated more strongly (R²> 0.95) for any reagent/drug combination than patient samples (R² ranged from 0.29-0.86). Dabigatran calibrator results and patient data were equivalent for SynthASil and PTT-A APTT reagents. The dabigatran and rivaroxaban calibrator material over-estimated drug sensitivity for all PT reagents when compared to sensitivity data calculated based on drug levels obtained by LC-MS/MS from patient samples. In conclusion, drug-specific calibrators overestimated reagent sensitivity which may underestimate in vivo drug concentration in a given patient. Further studies are required to assess whether this method of determining relative sensitivity of NOAC on routine coagulation assays should be recommended.
Collapse
Affiliation(s)
- R C Gosselin
- Robert C. Gosselin, University of California Davis Health System, Pathology and Laboratory Medicine, 2315 Stockton Blvd, Room 2P344, Davis, CA 95821, USA, Tel.: +1 916 7342490, Fax: +1 916 7036775, E-mail:
| | | | | | | | | | | |
Collapse
|
16
|
Schouten J, Wit FW, Stolte IG, Kootstra NA, van der Valk M, Geerlings SE, Prins M, Reiss P, Reiss P, Wit FWNM, van der Valk M, Schouten J, Kooij KW, van Zoest RA, Elsenga BC, Prins M, Stolte IG, Martens M, Moll S, Berkel J, Moller L, Visser GR, Welling C, Zaheri S, Hillebregt MMJ, Gras LAJ, Ruijs YMC, Benschop DP, Reiss P, Kootstra NA, Harskamp-Holwerda AM, Maurer I, Mangas Ruiz MM, Girigorie AF, van Leeuwen E, Janssen FR, Heidenrijk M, Schrijver JHN, Zikkenheiner W, Wezel M, Jansen-Kok CSM, Geerlings SE, Godfried MH, Goorhuis A, van der Meer JTM, Nellen FJB, van der Poll T, Prins JM, Reiss P, van der Valk M, Wiersinga WJ, Wit FWNM, van Eden J, Henderiks A, van Hes AMH, Mutschelknauss M, Nobel HE, Pijnappel FJJ, Westerman AM, de Jong J, Postema PG, Bisschop PHLT, Serlie MJM, Lips P, Dekker E, de Rooij SEJA, Willemsen JMR, Vogt L, Schouten J, Portegies P, Schmand BA, Geurtsen GJ, ter Stege JA, Klein Twennaar M, van Eck-Smit BLF, de Jong M, Richel DJ, Verbraak FD, Demirkaya N, Visser I, Ruhe HG, Nieuwkerk PT, van Steenwijk RP, Dijkers E, Majoie CBLM, Caan MWA, Su T, van Lunsen HW, Nievaard MAF, van den Born BJH, Stroes ESG, Mulder WMC. Cross-sectional Comparison of the Prevalence of Age-Associated Comorbidities and Their Risk Factors Between HIV-Infected and Uninfected Individuals: The AGEhIV Cohort Study. Clin Infect Dis 2014; 59:1787-97. [DOI: 10.1093/cid/ciu701] [Citation(s) in RCA: 498] [Impact Index Per Article: 49.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
|
17
|
Bouatou Y, Ferrari-Lacraz S, Moll S, Villard J, Martin P, Hadaya K. Prise en charge du rejet humoral tardif : comment éviter le rejet chronique ? Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Moll S, Lindley C, Pescatore S, Morrison D, Tsuruta K, Mohri M, Serada M, Sata M, Shimizu H, Yamada K, White GC. Phase I study of a novel recombinant human soluble thrombomodulin, ART-123. J Thromb Haemost 2014. [DOI: 10.1111/j.1538-7836.2003.tb05793.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
19
|
Hawes EM, Deal AM, Funk-Adcock D, Gosselin R, Jeanneret C, Cook AM, Taylor JM, Whinna HC, Winkler AM, Moll S. Performance of coagulation tests in patients on therapeutic doses of dabigatran: a cross-sectional pharmacodynamic study based on peak and trough plasma levels. J Thromb Haemost 2013; 11:1493-502. [PMID: 23718677 DOI: 10.1111/jth.12308] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Knowledge of anticoagulation status during dabigatran therapy may be desirable in certain clinical situations. OBJECTIVE To determine the coagulation tests that are most useful for assessing dabigatran's anticoagulant effect. METHODS Peak and trough blood samples from 35 patients taking dabigatran 150 mg twice daily, and one sample each from 30 non-anticoagulated individuals, were collected. Mass spectrometry and various coagulation assays were performed. 'Therapeutic range' was defined as the range of plasma dabigatran concentrations determined by mass spectrometry between the 2.5th and 97.5th percentiles of all values. RESULTS The therapeutic range was 27-411 ng mL(-1) . The prothrombin time (PT) and activated partial thromboplastin time (APTT), determined with multiple reagents, and activated clotting time (ACT) were insensitive to therapeutic dabigatran: 29%, 18% and 40% of samples had a normal PT, APTT, and ACT, respectively. However, normal PT, ACT and APTT ruled out dabigatran levels above the 75th percentile. The thrombin clotting time (TCT) correlated well and linearly with dabigatran levels below the 50th percentile, but was unmeasurable above it. The dilute thrombin time, ecarin clotting time and ecarin chromogenic assay showed linear correlations with dabigatran levels over a broad range, and identified therapeutic and supratherapeutic levels. CONCLUSIONS The prothrombin time, APTT and ACT are often normal in spite of therapeutic dabigatran plasma levels. The TCT is useful for detecting minimal dabigatran levels. The dilute thrombin time and chromogenic and clotting ecarin assays accurately identify therapeutic and supratherapeutic dabigatran levels. This trial is registered at www.clinicaltrials.gov (#NCT01588327).
Collapse
Affiliation(s)
- E M Hawes
- Department of Pharmacy, School of Medicine, Department of Family Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Moll S, Jourdan T, Lefaix-Jeuland H. Direct observation of interstitial dislocation loop coarsening in α-iron. Phys Rev Lett 2013; 111:015503. [PMID: 23863013 DOI: 10.1103/physrevlett.111.015503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Indexed: 06/02/2023]
Abstract
Interstitial loop coarsening by Ostwald ripening can provide insight into single point defects but is very difficult to observe in α-iron and many other metals where nanoscale vacancy clusters dissociate and annihilate loops. We show that by implanting helium in the samples at a carefully chosen energy, it is possible to observe Ostwald ripening of loops by transmission electron microscopy during in situ isochronal annealings. This coarsening of loops results in a sharp increase of the mean loop radius at around 850 K. Using cluster dynamics simulations, we demonstrate that loops evolve due to vacancy emission and that such experiments give a robust estimation of the sum of the formation and migration free energies of vacancies. In particular, our results are in good agreement with self-diffusion experiments and confirm that entropic contributions are large for the vacancy in α-iron.
Collapse
Affiliation(s)
- S Moll
- CEA, DEN, Service de Recherches de Métallurgie Physique, F-91191 Gif-sur-Yvette, France
| | | | | |
Collapse
|
21
|
Li Y, Mouche S, Sajic T, Veyrat-Durebex C, Supale R, Pierroz D, Ferrari S, Negro F, Hasler U, Feraille E, Moll S, Meda P, Deffert C, Montet X, Krause KH, Szanto I. Deficiency in the NADPH oxidase 4 predisposes towards diet-induced obesity. Int J Obes (Lond) 2012; 36:1503-13. [PMID: 22430302 DOI: 10.1038/ijo.2011.279] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE NADPH oxidase 4 (NOX4) is a reactive oxygen species (ROS) producing NADPH oxidase that regulates redox homeostasis in diverse insulin-sensitive cell types. In particular, NOX4-derived ROS is a key modulator of adipocyte differentiation and mediates insulin receptor signaling in mature adipocytes in vitro. Our study was aimed at investigating the role of NOX4 in adipose tissue differentiation, whole body metabolic homeostasis and insulin sensitivity in vivo. DESIGN Mice with genetic ablation of NOX4 (NOX4-deficient mice) were subjected to chow or high-fat-containing diet for 12 weeks. Body weight gain, adiposity, insulin sensitivity, and adipose tissue and liver gene and protein expression were analyzed and compared with similarly treated wild-type mice. RESULTS Here, we report that NOX4-deficient mice display latent adipose tissue accumulation and are susceptible to diet-induced obesity and early onset insulin resistance. Obesity results from accelerated adipocyte differentiation and hypertrophy, and an increase in whole body energy efficiency. Insulin resistance is associated with increased adipose tissue hypoxia, inflammation and adipocyte apoptosis. In the liver, more severe diet-induced steatosis was observed due to the lack of proper upregulation of mitochondrial fatty acid β-oxidation. CONCLUSION These findings identify NOX4 as a regulator of metabolic homeostasis. Moreover, they indicate an anti-adipogenic role for NOX4 in vivo and reveal its function as a protector against the development of diet-induced obesity, insulin resistance and hepatosteatosis.
Collapse
Affiliation(s)
- Y Li
- Department of Cellular Physiology and Metabolism, University of Geneva, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Hadaya K, Ferrari-Lacraz S, Fumeaux D, Boehlen F, Toso C, Moll S, Martin PY, Villard J. Eculizumab in acute recurrence of thrombotic microangiopathy after renal transplantation. Am J Transplant 2011; 11:2523-7. [PMID: 21831149 DOI: 10.1111/j.1600-6143.2011.03696.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Renal thrombotic microangiopathy (TMA) is a severe complication of systemic lupus erythematosus (SLE), which is associated with the presence of antiphospholipid (aPL) antibodies. In its most fulminant form, TMA leads to a rapid and irreversible end-stage renal failure. Eculizumab, an anti-C5 monoclonal antibody, is a novel therapy of choice for patients with paroxysmal nocturnal hemoglobinuria (PNH) and atypical hemolytic uremic syndrome. Here, we report the case of a 27-year-old woman, known for SLE and end-stage renal disease due to fulminant TMA. Both aPL antibodies and antinucleosome antibodies were positive. The patient underwent a living-related kidney transplantation with immediate production of urine. Although serum creatinine was remaining high, a graft biopsy, performed on day 6, demonstrated a TMA recurrence. Despite a treatment with plasma exchange, the situation got worse and dialysis was started. Eculizumab treatment was subsequently administered and renal function improved rapidly. Three months after transplantation, serum creatinine was at 100 μmol/L, without proteinuria. This case illustrates the benefit of eculizumab therapy in a fulminant recurrence of TMA after kidney transplantation, resistant to classical therapy.
Collapse
Affiliation(s)
- K Hadaya
- Division of Nephrology, University Hospital and Medical School, Geneva, Switzerland
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Ansari M, Vukicevic M, Rougemont AL, Moll S, Parvex P, Gumy-Pause F, Chalandon Y, Passweg J, Ozsahin H, Roosnek E. Do NK cells contribute to the pathophysiology of transplant-associated thrombotic microangiopathy? Am J Transplant 2011; 11:1748-52. [PMID: 21714846 DOI: 10.1111/j.1600-6143.2011.03617.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Transplant-associated thrombotic microangiopathy (TA-TMA) is a life-threatening complication caused by the aggregation of platelets exposed to the thrombogenic subendothelial matrix of injured endothelial cells. Here, we present a case of a patient transplanted for idiopathic aplastic anemia with a T-cell depleted hematopoietic stem cell graft from an HLA-C mismatched unrelated donor. At day 7 posttransplant, she suffered from acute renal failure with hematuria. The presence of numerous schistocytes, an increased level of lactate dehydrogenase and a renal biopsy with multiple vascular injuries confirmed the diagnosis of severe TA-TMA. At day 14, she developed graft versus host disease and died 7 months posttransplantation of multiorgan failure. At day 15, we observed a sizable population of natural killer (NK) cells in the peripheral blood, the number of which reached 0.8 G/L at 4 months posttransplant. Most NK cells lacked inhibitory killer immunoglobulin-like receptors (KIR) specific for the KIR-ligands expressed in the patient. NK cells were also abundantly present in pericardial and pleural fluids and had invaded the kidney, where they colocalized with the renal vasculopathy. Because there are several mechanisms through which NK cells and platelets can activate each other reciprocally, it is conceivable that NK cells contribute to TA-TMA and its progression.
Collapse
Affiliation(s)
- M Ansari
- Department of Pediatrics, University Hospital of Geneva, Switzerland.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Lombardi T, Moll S, Youinou P, Pers JO, Tzankov A, Gabay C, Santiago-Raber ML, Chizzolini C, Huard B. Absence of up-regulation for a proliferation-inducing ligand in Sjogren's sialadenitis lesions. Rheumatology (Oxford) 2011; 50:1211-5. [DOI: 10.1093/rheumatology/ker016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
|
25
|
Dettwiler S, McKee T, Hadaya K, Chappuis F, van Delden C, Moll S. Visceral leishmaniasis in a kidney transplant recipient: parasitic interstitial nephritis, a cause of renal dysfunction. Am J Transplant 2010; 10:1486-9. [PMID: 20486908 DOI: 10.1111/j.1600-6143.2010.03125.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Visceral leishmaniasis (VL) due to Leishmania infantum is an endemic parasitic infection in the Mediterranean area. It most commonly affects immunosuppressed individuals, especially HIV patients and less frequently organ transplant recipients. Renal involvement seems to be frequent and is mostly associated with tubulointerstitial nephritis, as described in autopsy reports. In the 61 cases of renal transplant recipients with VL reported in the literature, renal dysfunction was noted at clinical presentation and was more frequently observed as a complication of antiparasitic therapy. However, no pathological analysis of the allograft lesions was reported. We present the case of a Swiss renal transplant recipient who developed VL after vacations in Spain and Tunisia, complicated by acute parasitic nephritis in the renal allograft 3 months after a well-conducted treatment of liposomal amphotericin B.
Collapse
Affiliation(s)
- S Dettwiler
- Division of Clinical Pathology, University Hospital of Geneva, Switzerland
| | | | | | | | | | | |
Collapse
|
26
|
|
27
|
Moll S, Persons D. Fall 2337. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1233808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
28
|
|
29
|
|
30
|
|
31
|
|
32
|
|
33
|
Moll S, Thel M. Fall 2263. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1233920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
34
|
Moll S, Thel M. Fall 2256. Dtsch Med Wochenschr 2009. [DOI: 10.1055/s-0029-1233909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
35
|
|
36
|
|
37
|
|
38
|
|
39
|
|
40
|
|
41
|
|
42
|
|
43
|
|
44
|
Trendelenburg M, Lutz HU, Tissot JD, Moll S, Hoffmann T, Schifferli JA. Cryoglobulin/albumin complexes in a patient with severe autoimmune syndrome. Scand J Rheumatol 2009; 32:367-73. [PMID: 15080269 DOI: 10.1080/03009740410005043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We describe the case of a 30-year-old man with a severe autoimmune disease characterized by cryoglobulinaemia, pulmonary hypertension, Raynaud's phenomenon, lymphadenopathy, and glomerulonephritis. Despite initial remission following autologous stem cell transplantation, his disease relapsed and he died from pulmonary hypertension. At presentation the patient had hypergammaglobulinaemia and a number of autoantibodies, including rheumatoid factor (1:10240). The most striking feature was the extremely high level of cryoglobulins. The cryoprecipitate consisted of polyclonal IgM, IgG and albumin. Interestingly, the albumin in the cryoprecipitate was exclusively present in SS-bonded oligomeric forms, and contained an abnormal acidic component as judged by 2D gel electrophoresis. Oxidized albumin was also present in serum, and represented a small but significant fraction. None of the many known albumin variants have so far been associated with a particular disease; thus our results may represent the first description of an altered albumin associated with severe disease.
Collapse
|
45
|
|
46
|
Bourquin V, Guinand A, Haenni C, Giovannini M, Delouche D, Dettwiler S, Moll S. [Hemolytic uremic syndrome following gemcitabine treatment]. Rev Med Suisse 2008; 4:1056-1061. [PMID: 18557535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Hemolytic uremic syndrome (HUS) in children is classically associated with diarrheas related to the production of a shiga-toxin. HUS occurs among oncologic patients, in relation with the cancer itself, or as a complication of the cytostatic treatment. The physician should be familiar with the triad of HUS (microangiopathic hemolytic anemia, thrombocytopenia and renal failure) and search actively for this pathology in oncologic patient. The treatment is essentially empirical. It includes plasma exchanges, control of blood pressure, hydro-electrolytic balance control with dialysis, if necessary. Blood transfusion should be avoided. Potential mortal complications associated with HUS can be prevented by a rapid diagnosis and a prompt initiation of adequate therapy.
Collapse
Affiliation(s)
- V Bourquin
- Service de Néphrologie, HUG, 1211 Genève 14.
| | | | | | | | | | | | | |
Collapse
|
47
|
Ford SK, Misita CP, Shilliday BB, Malone RM, Moll S. Use of daily vitamin K supplementation in patients on warfarin with a history of frequent dose changes or variable INRs. J Thromb Thrombolysis 2008. [DOI: 10.1007/s11239-007-0136-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
48
|
Moll S. Unusual bleeds, unusual clots. Hamostaseologie 2007; 27:191-9. [PMID: 17694227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Nine unusual bleeding and clotting disorders (or mimickers of such) are described in the format of case presentations, with focus on clinical history, images and diagnostic tests, followed by a discussion of the disease itself and a summarizing clinical teaching point. The disease entities discussed are acquired factor VIII inhibitor, acquired von Willebrand factor inhibitor, haemophilic pseudotumour, Gardner-Diamond syndrome, coumarin-induced skin necrosis, purple toe syndrome, brachiocephalic vein thrombosis with breast enlargement, and leg swelling due to nephrogenic fibrosing dermopathy and lymphoedema. The publication is meant to demonstrate the fascination of clinical coagulation.
Collapse
Affiliation(s)
- S Moll
- University of North Carolina School of Medicine, Department of Medicine, Division of Hematology-Oncology, Chapel Hill, NC 27599, USA.
| |
Collapse
|
49
|
Moll S. Unusual bleeds, unusual clots. Hamostaseologie 2007. [DOI: 10.1055/s-0037-1616911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
SummaryNine unusual bleeding and clotting disorders (or mimickers of such) are described in the format of case presentations, with focus on clinical history, images and diagnostic tests, followed by a discussion of the disease itself and a summarizing clinical teaching point. The disease entities discussed are acquired factor VIII inhibitor, acquired von Willebrand factor inhibitor, haemophilic pseudotumour, Gardner-Diamond syndrome, coumarin-induced skin necrosis, purple toe syndrome, brachiocephalic vein thrombosis with breast enlargement, and leg swelling due to nephrogenic fibrosing dermopathy and lymphoedema. The publication is meant to demonstrate the fascination of clinical coagulation.
Collapse
|
50
|
Dowling NF, Beckman MG, Manco-Johnson M, Hassell K, Philipp CS, Michaels LA, Moll S, Heit JA, Penner J, Kulkarni R, Pipe S, Bockenstedt P, Andersen J, Crudder S, James AH, Zimmerman S, Ortel TL. The U.S. Thrombosis and Hemostasis Centers pilot sites program. J Thromb Thrombolysis 2006; 23:1-7. [PMID: 17111206 DOI: 10.1007/s11239-006-9002-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Venous thromboembolism (VTE) is a common disorder associated with significant morbidity and mortality. Despite important advances in understanding the etiology of VTE, delivery of care to patients with thrombosis and thrombophilia is frequently incomplete and highly variable. A comprehensive model of health care has been used successfully to treat and prevent complications for people with hemophilia and other chronic disorders. The effectiveness of an integrated healthcare model for patients with all coagulation disorders has yet to be evaluated. The Division of Hereditary Blood Disorders of the Centers for Disease Control and Prevention (CDC) is collaborating with eight Thrombosis and Hemostasis Centers (pilot sites) to provide health-related services and conduct research directed toward the reduction or prevention of complications of thrombosis and thrombophilia. The initial objectives of the collaboration are to (1) determine the efficacy of integrated multidisciplinary care and prevention services for people with hemostatic disorders, (2) assess unmet needs for service delivery and identify outreach strategies to improve access to care, (3) develop effective messages aimed at disease management and prevention, and (4) foster the development of training programs to enhance provider skills for the delivery of patient care. To address these objectives, the investigators and CDC have developed and implemented a web-based patient registry to follow prospectively service allocation and patient outcomes. Funding for the program began in October 2001. All eight funded centers are affiliated with U.S. medical schools. Principal investigators at the centers are hematologists (five adult, two pediatric) or cardiologists. Faculty in obstetrics-gynecology, surgery, and multiple other specialties are integral to the model of care at the centers. Other critical components at the centers are clinical laboratory services, training programs, research networks, and education and outreach programs. From August 2003 to March 2006, over 2,600 patients were enrolled in the registry, accounting for a total of more than 5,000 visits to the centers. Immediate goals of the data collection at the centers are to characterize patients receiving care at centers and document the state of health services provided. Long-term goals are to evaluate prospectively clinical outcomes for patients receiving multidisciplinary care and prevention services at centers. The network of data collection across centers will facilitate future collaborative clinical and epidemiologic investigations and enhance collective expertise in hemostasis and coagulation disorders.
Collapse
Affiliation(s)
- N F Dowling
- Division of Hereditary Blood Disorders, National Center on Birth Defects and Developmental Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|