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1.
Haemostasis ; 28(1): 31-6, 1998.
Article in English | MEDLINE | ID: mdl-9885368

ABSTRACT

Congenital resistance to activated protein C due to a point mutation in the factor V gene (Gln506-FV) is the most common genetic risk factor for familial venous thrombosis. Considering the central role of activated protein C as a physiological anticoagulant, the question of why the thrombotic risk associated with Gln506-FV was not more pronounced was asked. We hypothesized that in Gln506-FV heterozygotes, enhanced thrombin formation might preferentially activate protein C and thereby constitute a compensatory antithrombotic effect. We compared the circulatory level of activated protein C in twelve heterozygous carriers of Gln506-FV mutation with that in eighteen noncarriers in same families, and used prothrombin fragment 1+2 as a measure of thrombin generation. The circulating level of activated protein C was higher but not significantly different in heterozygotes compared with normal relatives. Activated protein C levels correlated strongly and positively with protein C antigen levels in both carriers (Spearman R 0.684, p < 0.05) and controls (Spearman R 0.642, p < 0.01). Correlation between activated protein C and prothrombin fragment 1+2 levels was of borderline significance (Spearman R 0.354, p = 0.055). In the current study, thrombin formation assessed by prothrombin fragment 1+2 levels was not significantly enhanced in subjects with heterozygous Gln506-FV compared with family members without the mutation. In conclusion, enhanced thrombin formation is not present in all healthy Gln506-FV heterozygotes in basal conditions. It seems that enhanced protein C activation by thrombin does not constitute a compensatory anticoagulant feedback loop in heterozygous carriers of Gln506-FV. However, the positive correlation between prothrombin fragment 1+2 and activated protein C suggests that, in healthy subjects and in basal conditions, thrombin upregulates the anticoagulant protein C pathway. Thus, it is questionable whether prothrombin fragment 1+2 can directly be used as an indicator of a hypercoagulable state.


Subject(s)
Factor V/genetics , Genetic Carrier Screening , Glutamine/genetics , Protein C/analysis , Adolescent , Adult , Aged , Enzyme Activation , Female , Humans , Male , Middle Aged , Mutation
3.
Disabil Rehabil ; 18(3): 143-8, 1996 Mar.
Article in English | MEDLINE | ID: mdl-8695886

ABSTRACT

Outcome of rehabilitation programmes emphasizing intensive cooperation between workplace and rehabilitation specialists was evaluated. Outcome of rehabilitation was assessed 6 months after the beginning of the rehabilitation process. Outcome measures presented here were based on questionnaires. Benefits of changes in work-related factors (e.g. ergonomics) carried out after the programme at the workplace were also assessed. The results showed significant improvement in the subjects' working capacity, as well as a decrease in symptom severity and disability caused by individual and work-related factors. Improvements in working methods and work tasks during the follow-up period were connected to better outcome.


Subject(s)
Musculoskeletal Diseases/rehabilitation , Occupational Diseases/rehabilitation , Female , Humans , Male , Middle Aged , Pain Measurement , Pilot Projects , Treatment Outcome
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