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Rovenchak A, Druchok M. Machine learning-assisted search for novel coagulants: When machine learning can be efficient even if data availability is low. J Comput Chem 2024; 45:937-952. [PMID: 38174834 DOI: 10.1002/jcc.27292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/10/2023] [Indexed: 01/05/2024]
Abstract
Design of new drugs is a challenging process: a candidate molecule should satisfy multiple conditions to act properly and make the least side-effect-perfect candidates selectively attach to and influence only targets, leaving off-targets intact. The amount of experimental data about various properties of molecules constantly grows, promoting data-driven approaches. However, the applicability of typical predictive machine learning techniques can be substantially limited by a lack of experimental data about a particular target. For example, there are many known Thrombin inhibitors (acting as anticoagulants), but a very limited number of known Protein C inhibitors (coagulants). In this study, we present our approach to suggest new inhibitor candidates by building an effective representation of chemical space. For this aim, we developed a deep learning model-autoencoder, trained on a large set of molecules in the SMILES format to map the chemical space. Further, we applied different sampling strategies to generate novel coagulant candidates. Symmetrically, we tested our approach on anticoagulant candidates, where we were able to predict their inhibition towards Thrombin. We also compare our approach with MegaMolBART-another deep learning generative model, but exploiting similar principles of navigation in a chemical space.
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Affiliation(s)
- Andrij Rovenchak
- SoftServe, Inc., Lviv, Ukraine
- Professor Ivan Vakarchuk Department for Theoretical Physics, Ivan Franko National University of Lviv, Lviv, Ukraine
| | - Maksym Druchok
- SoftServe, Inc., Lviv, Ukraine
- Institute for Condensed Matter Physics, Lviv, Ukraine
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van Haeren MMT, Raasveld SJ, Karami M, Miranda DDR, Mandigers L, Dauwe DF, De Troy E, Pappalardo F, Fominskiy E, van den Bergh WM, Oude Lansink-Hartgring A, van der Velde F, Maas JJ, van de Berg P, de Haan M, Donker DW, Meuwese CL, Taccone FS, Peluso L, Lorusso R, Delnoij TSR, Scholten E, Overmars M, Ivancan V, Bojčić R, de Metz J, van den Bogaard B, de Bakker M, Reddi B, Hermans G, Broman LM, Henriques JPS, Schenk J, Vlaar APJ, Müller MCA. Plasma Transfusion and Procoagulant Product Administration in Extracorporeal Membrane Oxygenation: A Secondary Analysis of an International Observational Study on Current Practices. Crit Care Explor 2023; 5:e0949. [PMID: 37614800 PMCID: PMC10443757 DOI: 10.1097/cce.0000000000000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES To achieve optimal hemostatic balance in patients on extracorporeal membrane oxygenation (ECMO), a liberal transfusion practice is currently applied despite clear evidence. We aimed to give an overview of the current use of plasma, fibrinogen concentrate, tranexamic acid (TXA), and prothrombin complex concentrate (PCC) in patients on ECMO. DESIGN A prespecified subanalysis of a multicenter retrospective study. Venovenous (VV)-ECMO and venoarterial (VA)-ECMO are analyzed as separate populations, comparing patients with and without bleeding and with and without thrombotic complications. SETTING Sixteen international ICUs. PATIENTS Adult patients on VA-ECMO or VV-ECMO. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Of 420 VA-ECMO patients, 59% (n = 247) received plasma, 20% (n = 82) received fibrinogen concentrate, 17% (n = 70) received TXA, and 7% of patients (n = 28) received PCC. Fifty percent of patients (n = 208) suffered bleeding complications and 27% (n = 112) suffered thrombotic complications. More patients with bleeding complications than patients without bleeding complications received plasma (77% vs. 41%, p < 0.001), fibrinogen concentrate (28% vs 11%, p < 0.001), and TXA (23% vs 10%, p < 0.001). More patients with than without thrombotic complications received TXA (24% vs 14%, p = 0.02, odds ratio 1.75) in VA-ECMO, where no difference was seen in VV-ECMO. Of 205 VV-ECMO patients, 40% (n = 81) received plasma, 6% (n = 12) fibrinogen concentrate, 7% (n = 14) TXA, and 5% (n = 10) PCC. Thirty-nine percent (n = 80) of VV-ECMO patients suffered bleeding complications and 23% (n = 48) of patients suffered thrombotic complications. More patients with than without bleeding complications received plasma (58% vs 28%, p < 0.001), fibrinogen concentrate (13% vs 2%, p < 0.01), and TXA (11% vs 2%, p < 0.01). CONCLUSIONS The majority of patients on ECMO receive transfusions of plasma, procoagulant products, or antifibrinolytics. In a significant part of the plasma transfused patients, this was in the absence of bleeding or prolonged international normalized ratio. This poses the question if these plasma transfusions were administered for another indication or could have been avoided.
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Affiliation(s)
- Maite M T van Haeren
- Department of Critical Care, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
| | - Senta Jorinde Raasveld
- Department of Critical Care, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
| | - Mina Karami
- Department of Cardiology, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
| | - Dinis Dos Reis Miranda
- Adult Intensive Care Unit, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Loes Mandigers
- Adult Intensive Care Unit, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Dieter F Dauwe
- Department of Intensive Care Medicine, Surgical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Erwin De Troy
- Department of Intensive Care Medicine, Surgical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Federico Pappalardo
- Cardiothoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Allesandria, Italy
| | - Evgeny Fominskiy
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Walter M van den Bergh
- Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | | | - Jacinta J Maas
- Adult Intensive Care Unit, Leiden University Medical Center, Leiden, the Netherlands
| | - Pablo van de Berg
- Adult Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
| | - Maarten de Haan
- Department of Extracorporeal Circulation, Catharina hospital Eindhoven, the Netherlands
| | - Dirk W Donker
- Intensive Care Center, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
- Cardiovascular and Respiratory Physiology Group, TechMed Centre, University of Twente, Enschede, the Netherlands
| | - Christiaan L Meuwese
- Adult Intensive Care Unit, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Fabio Silvio Taccone
- Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme Bruxelles, Brussels, Belgium
| | - Lorenzo Peluso
- Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme Bruxelles, Brussels, Belgium
| | - Roberto Lorusso
- Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Thijs S R Delnoij
- Department of Intensive Care, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Erik Scholten
- Department of Intensive Care, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Martijn Overmars
- Department of Intensive Care, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Višnja Ivancan
- Department of Anesthesia and Intensive care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Robert Bojčić
- Department of Anesthesia and Intensive care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Jesse de Metz
- Department of Intensive Care, OLVG, Amsterdam, the Netherlands
| | | | - Martin de Bakker
- Department of Critical Care, Royal Adelaide Hospital, Adelaide, Australia
| | - Benjamin Reddi
- Department of Critical Care, Royal Adelaide Hospital, Adelaide, Australia
| | - Greet Hermans
- Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Lars Mikael Broman
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - José P S Henriques
- Department of Cardiology, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
| | - Jimmy Schenk
- Department of Critical Care, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, location AMC, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
- Department of Anesthesiology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Critical Care, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
| | - Marcella C A Müller
- Department of Critical Care, Amsterdam University Medical Centers, location Academic Medical Centers, Amsterdam, the Netherlands
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Mahardawi B, Jiaranuchart S, Rochanavibhata S, Arunjaroensuk S, Mattheos N, Pimkhaokham A. The role of hemostatic agents after tooth extractions: A systematic review and meta-analysis. J Am Dent Assoc 2023:S0002-8177(23)00277-5. [PMID: 37367710 DOI: 10.1016/j.adaj.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/20/2023] [Accepted: 05/06/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Hemostatic agents are used to control bleeding after tooth extraction and have been compared with conventional measures (that is, sutures or gauze pressure) in several studies. The objective of this systematic review was to evaluate the benefits of topical hemostatic agents for controlling bleeding after tooth extractions, especially in patients receiving antithrombotic therapy. TYPES OF STUDIES REVIEWED The authors conducted a literature search in MEDLINE (PubMed), Scopus, and the Cochrane Central Register of Controlled Trials, including prospective human randomized clinical trials in which researchers compared hemostatic agents with conventional methods and reported the time to achieve hemostasis and postoperative bleeding events. RESULTS Seventeen articles were eligible for inclusion. Hemostatic agents resulted in a significantly shorter time to achieve hemostasis in both healthy patients and patients taking antithrombotic drugs (standardized mean difference, -1.02; 95% CI, -1.70 to -0.35; P = .003 and standardized mean difference, -2.30; 95% CI, -3.20 to -1.39; P < .00001, respectively). Significantly fewer bleeding events were noted when hemostatic agents were used (risk ratio, 0.62; 95% CI, 0.44 to 0.88; P = .007). All forms of hemostatic agents (that is, mouthrinse, gel, hemostatic plug, and gauze soaked with the agent) had better efficacy in reducing the number of postoperative bleeding events than conventional hemostasis measures, except for hemostatic sponges. However, this was based on a small number of studies in each subgroup. CONCLUSIONS The use of hemostatic agents seemed to offer better bleeding control after tooth extractions in patients on antithrombotic drugs than conventional measures. PRACTICAL IMPLICATIONS Findings of this systematic review may help clinicians attain more efficient hemostasis in patients requiring tooth extraction. This systematic review is registered in the PROSPERO database. The registration number is CRD42021256145.
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Matei E, Predescu AM, Șăulean AA, Râpă M, Sohaciu MG, Coman G, Berbecaru AC, Predescu C, Vâju D, Vlad G. Ferrous Industrial Wastes-Valuable Resources for Water and Wastewater Decontamination. Int J Environ Res Public Health 2022; 19:13951. [PMID: 36360832 PMCID: PMC9657322 DOI: 10.3390/ijerph192113951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/22/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Ferrous waste by-products from the metallurgical industry have a high potential for valorization in the context of the circular economy, and can be converted to value-added products used in environmental remediation. This research reviews the latest data available in the literature with a focus on: (i) sources from which these types of iron-based wastes originate; (ii) the types of ferrous compounds that result from different industries; (iii) the different methods (with respect to the circular economy) used to convert them into products applied in water and wastewater decontamination; (iv) the harmful effects ferrous wastes can have on the environment and human health; and (v) the future perspectives for these types of waste.
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Affiliation(s)
- Ecaterina Matei
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Andra Mihaela Predescu
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Anca Andreea Șăulean
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Maria Râpă
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Mirela Gabriela Sohaciu
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - George Coman
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Andrei-Constantin Berbecaru
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Cristian Predescu
- Faculty of Materials Sciences and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
| | - Dumitru Vâju
- ICPE Bistrita, 7 Parcului Street, 420035 Bistrita, Romania
| | - Grigore Vlad
- ICPE Bistrita, 7 Parcului Street, 420035 Bistrita, Romania
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Jachimowicz P, Cydzik-Kwiatkowska A. Coagulation and Flocculation before Primary Clarification as Efficient Solutions for Low-Density Microplastic Removal from Wastewater. Int J Environ Res Public Health 2022; 19:13013. [PMID: 36293592 PMCID: PMC9602620 DOI: 10.3390/ijerph192013013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/29/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
Microplastic (MP) removal from wastewater was investigated using various types and doses of commercial coagulants (PIX, PAX) and flocculants (FPM, PEL, FCT) before primary clarification in a wastewater treatment plant (WWTP). Dosing with FPM, PIX, and PEL caused small MPs (180-212 µm) to be transferred mainly to the settled sludge (up to 86.4% of MP at a dose of 5 mL FMP/m3), while dosing of FCT and PAX caused these MPs to be transferred to the floated sludge (up to 64% MP at a dose of 5 mL PAX/m3). The efficiency of MP removal from wastewater was the highest (90%) with 2.5 mL PAX/m3; the generated primary sludge had a low MP content and could be safely managed in subsequent stages of sludge treatment. At the highest doses, PIX significantly increased the removal of P-PO4 (up to 94%) and COD (up to 73%). FPM and FCT resulted in over 40% efficiency of ammonium removal-such disturbance in wastewater composition may negatively affect further biological treatment. Effective removal of MP in the mechanical part of WWTP resulting from coagulation and flocculation enables the safe use of the excess sludge for agricultural purposes.
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Roberts JC, Javed MJ, Lundy MK, Burns RM, Wang H, Tarantino MD. Characterization of laboratory coagulation parameters and risk factors for intraventricular hemorrhage in extremely premature neonates. J Thromb Haemost 2022; 20:1797-1807. [PMID: 35524764 PMCID: PMC9543331 DOI: 10.1111/jth.15755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Extremely premature neonates have increased risk for bleeding, perhaps the most devastating version of which being intraventricular hemorrhage (IVH). Limited data are available for coagulation parameters in this vulnerable population. OBJECTIVES We conducted a prospective cohort study characterizing coagulation laboratory parameters in extremely premature neonates 23-30 weeks gestational age (GA) and determined coagulation parameters and clinical risk factors associated with IVH. PATIENTS/METHODS One hundred twenty neonates 23-30 weeks GA were enrolled, and umbilical cord blood samples were obtained and processed at the time of birth. Coagulation parameters including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and activity assays for factors II, VII, IX, X, XIII, and XIII subunit A antigen were performed by standard methods. Clinical risk factors were analyzed for association with IVH. RESULTS Of the enrolled neonates, 29 (24.2%) experienced IVH. Persistent pulmonary hypertension (PPHN) independently predicted IVH risk with odds ratio (OR) 5.3 (95% confidence interval [CI] 1.1-24.3), P = .0338; and chronic lung disease (CLD) approached significance with OR 2.3 (95% CI 0.9-5.5), P = .0659. Coagulation parameters were evaluated for association with IVH, and there was no significant difference among coagulation tests in neonates with or without IVH or per GA. Reduced factor XIII subunit A showed significant association with death, P = .003. CONCLUSIONS We present a large, prospective study of laboratory coagulation parameters in extremely premature neonates, including factor X, factor XIII, and factor XIII subunit A not previously described in this population. These findings may impact clinical practice and should encourage additional study in this vulnerable population.
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Affiliation(s)
- Jonathan C. Roberts
- Bleeding & Clotting Disorders InstitutePeoriaIllinoisUSA
- Department of PediatricsUniversity of Illinois College of Medicine at PeoriaPeoriaIllinoisUSA
- OSF Healthcare Children’s Hospital of IllinoisPeoriaIllinoisUSA
| | - M. Jawad Javed
- Department of PediatricsUniversity of Illinois College of Medicine at PeoriaPeoriaIllinoisUSA
- OSF Healthcare Children’s Hospital of IllinoisPeoriaIllinoisUSA
| | - Molly K. Lundy
- OSF Healthcare Children’s Hospital of IllinoisPeoriaIllinoisUSA
| | - Rita M. Burns
- Bleeding & Clotting Disorders InstitutePeoriaIllinoisUSA
| | - Huaping Wang
- Department of PediatricsUniversity of Illinois College of Medicine at PeoriaPeoriaIllinoisUSA
| | - Michael D. Tarantino
- Bleeding & Clotting Disorders InstitutePeoriaIllinoisUSA
- Department of PediatricsUniversity of Illinois College of Medicine at PeoriaPeoriaIllinoisUSA
- OSF Healthcare Children’s Hospital of IllinoisPeoriaIllinoisUSA
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Rauch S, Müller HP, Dreyhaupt J, Ludolph AC, Kassubek J, Althaus K. Andexanet Alfa for Reversal of Factor Xa Inhibitors in Intracranial Hemorrhage: Observational Cohort Study. J Clin Med 2022; 11. [PMID: 35743469 DOI: 10.3390/jcm11123399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Intracranial hemorrhage (ICH) is associated with high mortality and morbidity, especially in patients under anticoagulative treatment. Andexanet alfa (AA) is a modified recombinant form of human factor Xa (FXa) developed for reversal of FXa-inhibitors, e.g., in the event of ICH, but experience is still limited. Methods: This monocentric retrospective observational cohort study included 46 patients with acute FXa-inhibitor-associated non-traumatic ICH (FXa-I-ICH) of whom 23 were treated with AA within 12 h after symptom onset, compared to 23 patients with usual care (UC). Volumetrically analyzed hematoma expansion (HE) in brain imaging, clinical outcome and incidence of adverse events were analyzed. Results: All patients (mean age 79.8 ± 7.2 years) were effectively anticoagulated. The cohort included severely ill patients with large hematoma volumes (median 20.4, IQR 7.8−39.0 mL). Efficacy, as assessed by HE in imaging, was very good in the AA-group. There was no (0.0%) relevant HE (>33%) in contrast to UC-group (26.1%). Nevertheless, we observed a high incidence of thromboembolic events (30.4% vs. 4.4%) and non-favorable outcomes (death/palliative condition) in 43.5% vs. 26.1%. Conclusions: There was no HE in the volumetric neuroimaging assessment in the AA-group, but clinical outcomes remained often worse. Large randomized trials for the use of AA in patients with acute FXa-inhibitor-associated ICH are needed to investigate the clinical outcome in consideration of the rates of thromboembolism.
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Mbye M, Ayyash M, Abu-Jdayil B, Kamal-Eldin A. The Texture of Camel Milk Cheese: Effects of Milk Composition, Coagulants, and Processing Conditions. Front Nutr 2022; 9:868320. [PMID: 35520282 PMCID: PMC9062519 DOI: 10.3389/fnut.2022.868320] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/02/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Numerous people in African, Middle Asian, Middle Eastern, and Gulf Cooperation Council (GCC) countries highly value camel milk (CM) as it plays a vital role in their diet. The protein composition of CM as well as the structure of its casein micelles differs significantly from bovine milk (BM). Cheeses made from CM have a weak curd and soft texture compared to those made from BM. This review article presents and discusses the effect of milk protein composition, processing conditions (pasteurization and high-pressure treatment), and coagulants (camel chymosin, organic acids, plant proteases) on the quality of CM cheeses. CM cheese's weak texture is due to compositional characteristics of the milk, including low κ-casein-to-β-casein ratio (≈0.05 in CM vs. ≈0.33 in BM), large micelle size, different whey protein components, and higher proteolytic activity than BM. CM cheese texture can be improved by preheating the milk at low temperatures or by high pressure. Supplementing CM with calcium has shown inconsistent results on cheese texture, which may be due to interactions with other processing conditions. Despite their structure, CM cheeses are generally well liked in sensory studies.
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Affiliation(s)
- Mustapha Mbye
- Department of Food Science, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Mutamed Ayyash
- Department of Food Science, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Basim Abu-Jdayil
- Department of Petroleum & Chemical Engineering, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Afaf Kamal-Eldin
- Department of Food Science, United Arab Emirates University, Al-Ain, United Arab Emirates
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Augustsson C, Norström E, Lind V, Martin M, Astermark J, Strandberg K. Validation of factor VIII activity for monitoring standard and extended half-life products and correlation to thrombin generation assays. Haemophilia 2021; 27:494-500. [PMID: 33866649 DOI: 10.1111/hae.14317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/01/2021] [Revised: 03/17/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Monitoring replacement therapy with standard and extended half-life (EHL) products is challenging, since one-stage assay (OSA) and chromogenic substrate assay (CSA) results may differ significantly. Recent recommendations include local validation of each new product with recovery within 20-30%, depending on activity level. AIM To validate factor VIII (FVIII) activity for monitoring products in clinical use on Atellica Coag and to correlate it with thrombin generation. METHODS Plasma samples spiked with Advate® , Elocta® , Adynovi® , Nuwiq® , NovoEight® and Afstyla® (0.05, 0.20, 0.50 and 0.80 IU/ml) were analysed using Atellica Coag 360 with CSA-1 (Coatest SP) and CSA-2 (FVIII chromogenic), and OSA (Actin FS). Thrombin generation was performed using two thrombin generation assays (TGA-1 (Thrombinoscope) and TGA-2 (Technothrombin). RESULTS All products at levels above 0.05 IU/ml, except Adynovi, showed acceptable recovery using CSA-1, whereas measurements using CSA-2 gave more results outside the target level. All products, except Afstyla, showed acceptable recovery using OSA. Correlation between CSA-1 and OSA was excellent (r2 =1.0) with biases of 6-32%, depending on FVIII product. A clear dose-response was seen for all thrombin generation parameters and products using both methods, except at low levels for lag time using TGA-1. With CSA-1 as an independent variable, the correlations to thrombin peak (measured with TGA-2) were good (r2 = .8-.9). CONCLUSION Our data revealed good correlation and acceptable bias between CSA and OSA using our sets of reagents, methods and analyser in spiked samples. Thrombin generation gave good correlation to CSA-1 factor activity and is a possible complement to factor activity assays.
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Affiliation(s)
- Cecilia Augustsson
- Department of Clinical Chemistry and Pharmacology, Division of Laboratory Medicine, Coagulation, University and Regional Laboratories Region Skåne, Malmö, Sweden
| | - Eva Norström
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Vivian Lind
- Department of Clinical Chemistry and Pharmacology, Division of Laboratory Medicine, Coagulation, University and Regional Laboratories Region Skåne, Malmö, Sweden
| | - Myriam Martin
- Department of Clinical Chemistry and Pharmacology, Division of Laboratory Medicine, Coagulation, University and Regional Laboratories Region Skåne, Malmö, Sweden
| | - Jan Astermark
- Department of Haematology, Oncology and Radiation Physics, Skåne University Hospital, and Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Karin Strandberg
- Department of Clinical Chemistry and Pharmacology, Division of Laboratory Medicine, Coagulation, University and Regional Laboratories Region Skåne, Malmö, Sweden
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Augustsson C, Norström E, Andersson NG, Zetterberg E, Astermark J, Strandberg K. Monitoring standard and extended half-life products in hemophilia: Assay discrepancies for factor VIII and IX in pre- and postinfusion samples. Res Pract Thromb Haemost 2020; 4:1114-1120. [PMID: 33134777 PMCID: PMC7590307 DOI: 10.1002/rth2.12421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 05/29/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Monitoring hemophilia treatment with extended half-life products is challenging for coagulation laboratories since factor assays may show substantial differences between results obtained with the one-stage assay (OSA) and the chromogenic substrate assay (CSA). OBJECTIVES The aim of this study was to evaluate and compare different factor assays and global coagulation methods. METHODS Factor VIII (FVIII) and IX (FIX) activities and global assay parameters were analyzed in pre- and postinfusion samples (5 patients 2 samples/product/method). RESULTS Samples containing FVIII products (NovoEight, Elocta, and Nuwiq) gave higher levels when measured with CSA compared to OSA. The correlation was excellent (r 2 ≥ .97) while biases of 42%-72% of mean (CSA-OSA) were obtained. With FVIII (OSA) as independent variable, the correlations to kaolin clot time (CT) and thrombin generation assay (TGA) peak were modest (r2 = .71-.72 and .64-.65, respectively), except for Nuwiq for which there was a poor correlation to TGA peak (r 2 = .08). Samples containing Alprolix, a FIX product, gave a smaller difference between activity levels (CSA-OSA), and the correlation was excellent (r 2 = .96). With FIX (CSA) as independent variable for both Alprolix and Refixia, the correlations to Innovin CT and TGA peaks were weak (r 2 = .33-.45 and .44-.76, respectively). CONCLUSIONS Our data show that factor activity assays differ between methods used and agents. These discrepancies indicate the value of having more than one type of assay available in the coagulation laboratory when monitoring hemophilia treatment with extended half-life products. Global assays gave complementary information indicated by the modest correlations to factor activities.
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Affiliation(s)
- Cecilia Augustsson
- Division of Laboratory Medicine, CoagulationDepartment of Clinical Chemistry and PharmacologyUniversity and Regional Laboratories Region SkåneMalmöSweden
| | - Eva Norström
- Division of Laboratory Medicine, CoagulationDepartment of Clinical Chemistry and PharmacologyUniversity and Regional Laboratories Region SkåneMalmöSweden
| | - Nadine Gretenkort Andersson
- Department of Hematology, Oncology and Radiation PhysicsCenter for Thrombosis and HemostasisSkåne University HospitalLund UniversityMalmöSweden
| | - Eva Zetterberg
- Department of Hematology, Oncology and Radiation PhysicsCenter for Thrombosis and HemostasisSkåne University HospitalLund UniversityMalmöSweden
| | - Jan Astermark
- Department of Hematology, Oncology and Radiation PhysicsCenter for Thrombosis and HemostasisSkåne University HospitalLund UniversityMalmöSweden
| | - Karin Strandberg
- Division of Laboratory Medicine, CoagulationDepartment of Clinical Chemistry and PharmacologyUniversity and Regional Laboratories Region SkåneMalmöSweden
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11
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Yada K, Nogami K. Novel Insights and New Developments Regarding Coagulation Revealed by Studies of the Anti-Factor IXa (Activated Factor IX)/Factor X Bispecific Antibody, Emicizumab. Arterioscler Thromb Vasc Biol 2020; 40:1148-1154. [PMID: 32237902 DOI: 10.1161/atvbaha.120.312919] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Emicizumab is a humanized anti-FIXa/FX (factor IXa/X) bispecific monoclonal antibody that mimics FVIIIa (activated factor VIII) cofactor function. The hemostatic efficacy of emicizumab has been confirmed in clinical studies of patients with hemophilia A, irrespective of the presence of FVIII inhibitors. Emicizumab differs in some properties from FVIIIa molecule. Emicizumab requires no activation by thrombin and is not inactivated by activated protein C, but emicizumab-mediated coagulation is regulatable and maintains hemostasis. A small amount of FIXa (activated factor IX) is required to initiate emicizumab-mediated hemostasis, whereas tissue factor/FVIIa (activated factor VII)-mediated FXa (activated factor X) and thrombin activation initiates FVIIIa-mediated hemostasis. Fibrin formation, followed by fibrinolysis, appears to be similar between emicizumab- and FVIIIa-mediated hemostasis. These results suggest possible future uses of emicizumab for treating hemorrhagic diseases other than hemophilia A and reveal previously unobservable behaviors of procoagulation and anticoagulation factors in conventional hemostasis. Here, we have reviewed novel insights and new developments regarding coagulation highlighted by emicizumab.
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Affiliation(s)
- Koji Yada
- From the Department of Pediatrics (K.Y., K.N.), Nara Medical University, Kashihara, Japan.,The Course of Hemophilia Education (K.Y.), Nara Medical University, Kashihara, Japan
| | - Keiji Nogami
- From the Department of Pediatrics (K.Y., K.N.), Nara Medical University, Kashihara, Japan
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12
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Noh SH, Park H, Eom W, Lee HB, Kang DJ, Cho JY, Sung TH, Han TH. Graphene Foam Cantilever Produced via Simultaneous Foaming and Doping Effect of an Organic Coagulant. ACS Appl Mater Interfaces 2020; 12:10763-10771. [PMID: 31985203 DOI: 10.1021/acsami.9b19498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Inspired by the role of cellular structures, which give three-dimensional robustness to graphene structures, a new type of graphene cantilever with mechanical resilience is introduced. Here, NH4SCN is incorporated into graphene oxide (GO) gel using it as a coagulant for GO fiber self-assembly, a foaming agent, and a dopant. Subsequent thermal treatment of the GO fiber at 600 °C results in the evolution of gaseous species from NH4SCN, yielding internally porous graphene cantilevers (NS-GF cantilevers). The results reveal that NS-GF cantilevers are doped with N and S and thus exhibit higher electrical conductivity (150 S cm-1) than that of their nonporous counterparts (38.4 S cm-1). Unlike conventional fibers, the NS-GF cantilevers exhibit mechanical resilience by bending under applied mechanical force but reverting to the original position upon release. The tip of the NS-GF cantilevers is coated with magnetic Fe3O4 particles, and fast mechanical movement is achieved by applying the magnetic field. Since the NS-GF cantilevers are highly conductive and elastic, they are employed as bendable, magnetodriven electrical switches that could precisely read on/off signals for >10 000 cycles. Our approach suggests a robust fabrication strategy to prepare highly electroconductive and mechanically elastic foam structures by introducing unique organic foaming agents.
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Affiliation(s)
- Sung Hyun Noh
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Hun Park
- Department of Materials Science and Engineering, Northwestern University, Evanston, Illinois 60208, United States
| | - Wonsik Eom
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Hak Bong Lee
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Dong Jun Kang
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Jae Yong Cho
- Department of Electrical Bio-Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Tae Hyun Sung
- Department of Electrical Bio-Engineering, Hanyang University, Seoul 04763, Republic of Korea
| | - Tae Hee Han
- Department of Organic and Nano Engineering, Hanyang University, Seoul 04763, Republic of Korea
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13
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Cai J, Ribkoff J, Olson S, Raghunathan V, Al-Samkari H, DeLoughery TG, Shatzel JJ. The many roles of tranexamic acid: An overview of the clinical indications for TXA in medical and surgical patients. Eur J Haematol 2019; 104:79-87. [PMID: 31729076 DOI: 10.1111/ejh.13348] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [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: 08/06/2019] [Revised: 11/08/2019] [Accepted: 11/09/2019] [Indexed: 12/14/2022]
Abstract
Clinically significant bleeding can occur as a consequence of surgery, trauma, obstetric complications, anticoagulation, and a wide variety of disorders of hemostasis. As the causes of bleeding are diverse and not always immediately apparent, the availability of a safe, effective, and non-specific hemostatic agent is vital in a wide range of clinical settings, with antifibrinolytic agents often utilized for this purpose. Tranexamic acid (TXA) is one of the most commonly used and widely researched antifibrinolytic agents; its role in postpartum hemorrhage, menorrhagia, trauma-associated hemorrhage, and surgical bleeding has been well defined. However, the utility of TXA goes beyond these common indications, with accumulating data suggesting its ability to reduce bleeding and improve clinical outcomes in the face of many different hemostatic challenges, without a clear increase in thrombotic risk. Herein, we review the literature and provide practical suggestions for clinical use of TXA across a broad spectrum of bleeding disorders.
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Affiliation(s)
- Johnny Cai
- Department of Internal Medicine, Oregon Health and Science University, Portland, Oregon
| | - Jessica Ribkoff
- School of Medicine, Oregon Health and Science University, Portland, Oregon
| | - Sven Olson
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Vikram Raghunathan
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Hanny Al-Samkari
- Division of Hematology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Thomas G DeLoughery
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
| | - Joseph J Shatzel
- Division of Hematology and Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, Oregon
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14
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Cheng LJ, Hunag TL, Cheng Y, Zhang SS, Ruan ZY, Lu L. [Effects of Different Coagulants on Co-manganese Oxides Filter Media for Removing Ammonium and Manganese from Surface Water in Summer and Autumn]. Huan Jing Ke Xue 2019; 40:5294-5301. [PMID: 31854600 DOI: 10.13227/j.hjkx.201905003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Under high temperatures in summer and autumn, the effects of FeCl3, PFC, and PAFC on co-manganese oxides filter media for removing ammonium and manganese from surface water were investigated. The results showed that FeCl3 can be hydrolyzed easily, thus reducing the pH of the water and the residual iron in the water were not conducive to the removal of ammonium and manganese. Transforming the coagulant FeCl3 into PFC can effectively recover the removal effect of ammonium and manganese. After being pre-treated by PAFC, removal of ammonium and manganese during the filtering operation remained stable and excellent. Simultaneously, the structural characteristics of the filter material were analyzed. Different coagulants caused different changes of shape of filter media. As FeCl3 is a coagulant, the slow increase in specific surface area is not beneficial to removal of ammonium and manganese. Additionally, the results of FTIR spectra indicated that coagulants have different influences on the group of Fe-OH bonds of filter media. This study provides a theoretical basis for the study of the effects of water quality factors on the removal of ammonium and manganese from surface water.
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Affiliation(s)
- Li-Jie Cheng
- Shaanxi Key Laboratory of Environmental Engineering, School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Laboratory of Northwest Water Resource, Environment and Ecology, Ministry of Education, School of Environmental and Municipal Engineering, Xi'an University Architecture and Technology, Xi'an 710055, China
| | - Ting-Lin Hunag
- Shaanxi Key Laboratory of Environmental Engineering, School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Laboratory of Northwest Water Resource, Environment and Ecology, Ministry of Education, School of Environmental and Municipal Engineering, Xi'an University Architecture and Technology, Xi'an 710055, China
| | - Ya Cheng
- Shaanxi Key Laboratory of Environmental Engineering, School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Laboratory of Northwest Water Resource, Environment and Ecology, Ministry of Education, School of Environmental and Municipal Engineering, Xi'an University Architecture and Technology, Xi'an 710055, China
| | - Sha-Sha Zhang
- Shaanxi Key Laboratory of Environmental Engineering, School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Laboratory of Northwest Water Resource, Environment and Ecology, Ministry of Education, School of Environmental and Municipal Engineering, Xi'an University Architecture and Technology, Xi'an 710055, China
| | - Zhao-Yi Ruan
- Shaanxi Key Laboratory of Environmental Engineering, School of Environmental and Municipal Engineering, Xi'an University of Architecture and Technology, Xi'an 710055, China
- Key Laboratory of Northwest Water Resource, Environment and Ecology, Ministry of Education, School of Environmental and Municipal Engineering, Xi'an University Architecture and Technology, Xi'an 710055, China
| | - Lei Lu
- China Xi'an Waterworks Co., Ltd., Xi'an 710082, China
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15
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Scheres LJJ, Lijfering WM, Middeldorp S, Cheung YW, Barco S, Cannegieter SC, Coppens M. Measurement of coagulation factors during rivaroxaban and apixaban treatment: Results from two crossover trials. Res Pract Thromb Haemost 2018; 2:689-695. [PMID: 30349888 PMCID: PMC6178718 DOI: 10.1002/rth2.12142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 05/16/2018] [Accepted: 06/29/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Prediction models for venous thromboembolism recurrence will likely be improved by adding levels of coagulation factors. Risk assessment is ideally performed during anticoagulant treatment, however, the influence of direct oral anticoagulants on coagulation factors is uncertain. OBJECTIVE To assess the influence of rivaroxaban and apixaban on several coagulation factor levels. METHODS In two crossover trials we assessed the influence of rivaroxaban and apixaban intake on factor (F)VIII, FXI and FXII-activity and fibrinogen, von Willebrand factor (VWF:Ag), and d-dimer levels. At three sessions with a washout period in between, blood was taken from 12 healthy male individuals immediately before intake of rivaroxaban 15 mg twice daily (n = 6) or apixaban 10 mg twice daily (n = 6) and three hours after the last intake. RESULTS Overall, measured levels were lower after rivaroxaban/apixaban intake. The paired mean difference after rivaroxaban intake was -38 IU/dL (95% CI -43; -33) for FVIII:C, -29 U/dL (95% CI -45; -12) for FXI:C, -22 IU/dL (95% CI -43; -1) for FXII:C, -0.11 g/L (95% CI -0.25; 0.03) for fibrinogen, -7 IU/dL (95% CI -18; 3) for VWF:Ag, -27 ng/mL (95% CI -50; -4) for d-dimer and -0.36 (95% CI -0.57; -0.15) for Ln d-dimer. After apixaban intake this was -29 IU/dL (95% CI -38; -21) for FVIII:C, -29 IU/dL (95% CI -36; -22) for FXI:C, -19 IU/dL (95% CI -24; -15) for FXII:C, -0.18 g/L (95% CI -0.33; 0.03) for fibrinogen, -52 ng/mL (95% CI -100; -4) for d-dimer, 0.25 (-0.60; 0.09) for Ln d-dimer and 1 IU/dL (95% CI -7; 9) for VWF:Ag. CONCLUSION FVIII:C, FXI:C, FXII:C, and d-dimer measurements were influenced by rivaroxaban/apixaban intake, while fibrinogen and VWF:Ag were not.
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Affiliation(s)
- Luuk J. J. Scheres
- Department of Vascular MedicineAcademic Medical CenterAmsterdamthe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Willem M. Lijfering
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
- Department of Internal Medicine, Section Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Saskia Middeldorp
- Department of Vascular MedicineAcademic Medical CenterAmsterdamthe Netherlands
| | - Yuk W. Cheung
- Department of Vascular MedicineAcademic Medical CenterAmsterdamthe Netherlands
| | - Stefano Barco
- Department of Vascular MedicineAcademic Medical CenterAmsterdamthe Netherlands
- Center for Thrombosis and HemostasisUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Suzanne C. Cannegieter
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
- Department of Internal Medicine, Section Thrombosis and HemostasisLeiden University Medical CenterLeidenthe Netherlands
| | - Michiel Coppens
- Department of Vascular MedicineAcademic Medical CenterAmsterdamthe Netherlands
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16
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Weiss N, Schenk B, Bachler M, Solomon C, Fries D, Hermann M. FITC-linked Fibrin-Binding Peptide and real-time live confocal microscopy as a novel tool to visualize fibrin(ogen) in coagulation. J Clin Transl Res 2017; 3:276-282. [PMID: 30873479 PMCID: PMC6410668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 10/25/2022] Open
Abstract
Background and Aim: Although fibrinogen has been established as a key player in the process of coagulation, many questions about the role of fibrinogen under specific conditions remain. Confocal microscopic assessment of clot formation, and in particular the role that fibrinogen plays in this process, is commonly investigated using pre-labeled fibrinogen. This has a number of drawbacks, primarily that it is impossible to stain fibrin networks after their formation. The aim of the present study is to present an alternative for conveniently post-staining fibrin in a wide range of models/situations, in real time and with high resolution. Methods: We combined a peptide known to bind fibrin and linked it to fluorescein isothiocyanate (FITC), creating the FITC-Fibrin-Binding Peptide (FFBP). We subsequently tested its fibrin-binding capability in vitro under static conditions, as well as under simulated flow, using real-time live confocal microscopy. Results: Fibrin stained with FFBP overlaps with fibrin stained with fibrinogen pre-labeled with Alexa Fluor 647 following coagulation induction. In contrast to pre-labeled fibrinogen, FFBP also stains already formed fibrin networks. By combining FFBP with real-time live confocal microscopy even the visualization of single fibrin fibers is possible. Conclusions: These data indicate that FFBP is a valid and valuable tool for real-time live confocal assessment of clot formation. Relevance for patients: Our findings present a valuable alternative for the visualization of fibrin even after its formation, and we believe this approach will be particularly valuable for future investigations of important, but previously overlooked, aspects of clot formation.
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Affiliation(s)
- Nikolaj Weiss
- Department of Anesthesiology and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Bettina Schenk
- Department of General and Surgical Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Mirjam Bachler
- Institute for Sports Medicine, Alpine Medicine and Health Tourism, UMIT - University for Health Sciences, Medical Informatics and Technology, Hall, Austria
| | - Cristina Solomon
- Department of Anesthesiology, Perioperative Medicine and General Intensive Care, Paracelsus Medical University, Salzburg, Austria, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology and AUVA Research Centre, Vienna, Austria
| | - Dietmar Fries
- Department of General and Surgical Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Martin Hermann
- Department of Anesthesiology and Critical Care Medicine, Medical University Innsbruck, Innsbruck, Austria
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