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4.
J Clin Med ; 11(16)2022 Aug 12.
Article in English | MEDLINE | ID: mdl-36012950

ABSTRACT

BACKGROUND: The aim of the study is to evaluate selected biomarkers of bone turnover, inflammation, neutrophil trap and factors predisposing haemophiliacs to bone loss, and to analyse their relationship with clinical features, treatment and complications. METHODS: The levels of interleukin 6 (IL-6); citrullinated histone (CH3); osteocalcin (BGLAP); bone alkaline phosphatase (BALP); N-terminal procollagen type I propeptide (P1NP); and C-terminal collagen type I telopeptide (C1CP) were examined in 60 patients with haemophilia. RESULTS: The cut-off value for BGLAP is 26.41 ng/mL, and 929.7 pg/mL for CH3. There is a statistically significant difference between BGLAP, BALP, C1CP and CH3 concentrations, depending on the prophylaxis used. The median concentration of BGLAP in patients taking the factor on demand is 28.0 ng/mL, BALP 322.5 U/L, C1CP 191.2 ng/mL and CH3 1114.4 pg/mL. In patients taking recombinant coagulation factor VIII/IX as prophylaxis of bleeding, the median BGLAP concentrations are 35.9 ng/mL, BALP 280.9 U/L, C1CP 161.6 ng/mL and CH3 952.5 pg/mL. BGLAP and BALP concentrations are dependent on the development of haemophilic arthropathic. CONCLUSIONS: The concentrations of selected markers of bone turnover and NETs may help to identify patients at particular risk of developing haemophilic arthropathy and bone metabolic turnover abnormalities.

5.
J Clin Med ; 11(12)2022 Jun 13.
Article in English | MEDLINE | ID: mdl-35743462

ABSTRACT

Background: The study aimed to evaluate radiomorphometric indices derived from panoramic X-rays and selected blood markers of bone turnover and neutrophil extracellular traps, with a view to identifying hemophilic patients at risk of developing osteoporosis. Methods: The study consisted of 50 adult men with hemophilia A and B (mild, moderate, and severe). The control group consisted of 25 healthy adult men. In both groups, blood samples were collected to determine concentrations of citrullinated histone H3 (CH3) and osteocalcin (BGLAP) with ELISA tests, and panoramic X-rays were obtained. Images were imported into AudaXCeph software to calculate two radiomorphometric indices: mental index (MI) and panoramic mandibular index (PMI). Concentrations of BGLAP and CH3 were compared with MI and PMI values in patients with and without hemophilia. Results: There were statistically significant differences in BGLAP, CH3, and PMI between the study and the control group (p < 0.05). Multivariate logistic regression analysis showed a predictive value for PMI, BGLAP, and CH3.The ROC curve with cutoff point (Youden index) at 0.40­PMI was calculated. No correlation was observed for the PMI index in any particular subgroup of patients. No correlation between MI and BGLAP/CH3 was observed. Conclusions: Simultaneous use of PMI value and BGLAP and CH3 levels may allow the identification of patients with hemophilia who requirea detailed diagnosis of osteoporosis with DXA.

6.
Oncotarget ; 8(35): 60001-60014, 2017 Aug 29.
Article in English | MEDLINE | ID: mdl-28938703

ABSTRACT

Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied. We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence. ROTEM assays (INTEM, EXTEM, FIBTEM, APTEM) were performed on day -10, on the day of stem cell infusion (day 0) and on days +12 and +28 post-HSCT. The diagnosis of SOS/VOD was based on the Baltimore criteria. Seven patients (26%) developed SOS/VOD. On day +12, the patients with SOS/VOD had statistically significant longer INTEM-CT (clotting time, 199 ± 33.41vs166 ± 23.65s, p = 0.0033), EXTEM-CT (69.5 ± 6.39vs.52 ± 3.42s, p = 0.0139) and FIBTEM-CT (69.5 ± 22.75vs. 50.8 ± 14.31s, p = 0.0124) compared to SOS/VOD (-). ROC curve on day +12 indicated a cut-off value of 179s in INTEM-CT (AUC = 0.91), 69s in EXTEM-CT (AUC = 0.90) and 102s in FIBTEM-CT (AUC = 0.82) for the prediction of SOS/VOD. This is the first study evaluating the usefulness of ROTEM assays in the early detection of haemostasis abnormalities predictive of SOS/VOD development in patients undergoing HSCT for acute leukemia. Patients with SOS/VOD had a significant delay in the initiation of thrombin formation in the analysed ROTEM assays. The utility of ROTEM assays in the optimal management of patients undergoing HSCT should be clarified in further prospective studies.

7.
Int J Cardiol ; 202: 556-60, 2016 Jan 01.
Article in English | MEDLINE | ID: mdl-26447661

ABSTRACT

BACKGROUND: Patients with cyanotic congenital heart disease (CCHD) have an increased risk of bleeding and thrombotic complications. Prolonged conventional coagulation screening parameters, such as activated partial thromboplastin time or prothrombin time, are reported in less than 20% of CCHD patients. METHODS: The aim of this study was to determine the haemostatic abnormalities in 32 adult patients with CCHD by rotation thromboelastometry (ROTEM) with assessment of coagulation dynamic properties, as a guide for perioperative prophylaxis or haemostatic therapy. The control group consisted of 35 healthy subjects. RESULTS: Our results suggest that CCHD patients, in comparison to healthy controls, had a tendency to hypocoagulate with delayed activation of haemostasis and clot formation, initiated by both intrinsic and extrinsic activators. The growth of the clot was slower and the clot firmness was decreased, which may additionally contribute to bleeding diathesis. Moreover, the clot lysis readings suggest higher clot stability in the CCHD group. All velocity parameters were markedly lower in the CCHD patients, indicating a decreased rate of clot formation. Although coagulation tests and platelet count were normal, the usefulness of rotation thromboelastometry in monitoring or guiding therapy in CCHD patients is demonstrated. CONCLUSION: In conclusion, our results provide new insights into the data on hypocoagulation with impaired clot lysis in adult CCHD patients as determined by ROTEM. Our findings may assist in determining the optimal management of patients with CCHD undergoing surgery.


Subject(s)
Blood Coagulation/physiology , Cyanosis/pathology , Heart Diseases/congenital , Heart Diseases/pathology , Thrombelastography/methods , Adult , Aged , Anticoagulants/therapeutic use , Blood Coagulation Tests/methods , Cyanosis/blood , Cyanosis/complications , Female , Fibrinogen/physiology , Fibrinolysis/physiology , Heart Diseases/blood , Heart Diseases/complications , Hemorrhage/blood , Hemorrhage/complications , Hemorrhage/pathology , Hemostatic Techniques , Humans , Male , Middle Aged , Partial Thromboplastin Time/methods , Perioperative Care , Prothrombin Time , Thrombosis/blood , Thrombosis/complications , Thrombosis/pathology , Warfarin/therapeutic use , Young Adult
8.
Int J Hematol ; 101(4): 405-10, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25432436

ABSTRACT

Acquired von Willebrand syndrome (AVWS) is an acquired bleeding disorder with clinical and laboratory features similar to those of the inherited form of the disease. AVWS is reported in many disorders, most frequently in myeloproliferative neoplasms and in, among others, essential thrombocythemia (ET). Interestingly, ET is associated with both the thrombotic and haemorrhagic complications, which occur in 20 % and 5-30 % of patients, respectively. The present report concerns a 38-year-old man, suffering from ET, who presented with two episodes of post-arthroscopic joint bleeding after synovectomy required for the treatment of synovial hypertrophy and chronic left knee joint synovitis. We discuss the current diagnostic approaches, as well as the risk factors predisposing to bleeding and its management, in patients with essential thrombocythemia.


Subject(s)
Arthroscopy/adverse effects , Hemorrhage/etiology , Janus Kinase 2/genetics , Synovitis/surgery , Thrombocythemia, Essential/complications , von Willebrand Diseases/complications , Adult , Hemorrhage/diagnosis , Hemorrhage/genetics , Humans , Knee Joint/surgery , Male , Platelet Count , Point Mutation , Synovitis/complications , Synovitis/diagnosis , Synovitis/genetics , Thrombocythemia, Essential/diagnosis , Thrombocythemia, Essential/genetics , von Willebrand Diseases/diagnosis , von Willebrand Diseases/genetics , von Willebrand Factor/analysis
9.
Thromb Res ; 134(2): 404-11, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24931724

ABSTRACT

INTRODUCTION: Multiple myeloma (MM) therapy affects prothrombotic and anticoagulant processes. Patients receiving thalidomide, especially in combination with steroids, are at increased risk of venous thromboembolism (VTE), while the incidence of VTE on bortezomib is low. In vitro studies indicate that bortezomib causes a reduction in ADP-induced platelet aggregation. OBJECTIVES: To analyse the influence of bortezomib on platelet aggregation induced by various agonists in patients with MM. PATIENTS AND METHODS: A total of 30 patients (median age 57.5years) with relapsed/refractory MM receiving bortezomib-based regimens were analysed. Optical platelet aggregometry was performed with the agonists collagen, ADP and ristocetin and measured over two 21-day cycles. The results from two groups: those treated with bortezomib and thalidomide (BT group, n=11) and those without thalidomide (B group, n=19) were analysed. RESULTS: During the second cycle, significantly decreased platelet aggregation was observed in the B group: 5µM ADP (p=0.0285, day 1 versus 8); 3.5µM ADP (p=0.0005, day 1 versus 8 and day 1 versus 11), collagen (p=0.0014, day 4 versus 8, day 4 versus 11), 1.25mg/ml ristocetin (p=0.0017, day 1 versus 8 and day 1 versus 11). Agonist-induced platelet aggregation tended to be reduced over time during the 1st cycle in group B. In the thalidomide group, significant platelet aggregation inhibition by collagen only was found. Transient reduction in platelet count was observed in all patients, but more prominently in group B. CONCLUSION: The inhibitory effects of prolonged exposure of bortezomib on platelet aggregation were demonstrated in relapsed/refractory MM patients, but antithrombotic activity of bortezomib should be clarified in further prospective studies.


Subject(s)
Antineoplastic Agents/pharmacology , Boronic Acids/pharmacology , Multiple Myeloma/blood , Multiple Myeloma/drug therapy , Platelet Aggregation/drug effects , Pyrazines/pharmacology , Venous Thromboembolism/chemically induced , Adult , Aged , Angiogenesis Inhibitors/adverse effects , Angiogenesis Inhibitors/therapeutic use , Antineoplastic Agents/therapeutic use , Boronic Acids/therapeutic use , Bortezomib , Female , Humans , Male , Middle Aged , Platelet Function Tests , Prospective Studies , Pyrazines/therapeutic use , Thalidomide/adverse effects , Thalidomide/therapeutic use
10.
Blood Coagul Fibrinolysis ; 25(8): 912-5, 2014 Dec.
Article in English | MEDLINE | ID: mdl-24824490

ABSTRACT

Patients with haematological malignancies receiving concurrent treatment or after allogeneic stem cell transplantation (HSCT) are considered to be at increased risk for acquiring influenza A (H1N1) infection (pH1N1) and influenza-associated complications leading to increased mortality. We report of a series of haematological patients with severe course of laboratory-confirmed pH1N1, including two patients after HSCT. Coagulation assays were conducted and the association between coagulation activation and poor outcome pH1N1 infection was found in the analyzed group.


Subject(s)
Blood Coagulation , Hematologic Neoplasms/blood , Hematopoietic Stem Cell Transplantation , Influenza, Human/blood , Adult , Aged , Antineoplastic Agents/therapeutic use , Biomarkers/blood , Blood Coagulation Tests , Female , Hematologic Neoplasms/complications , Hematologic Neoplasms/mortality , Hematologic Neoplasms/therapy , Humans , Influenza A Virus, H1N1 Subtype/physiology , Influenza, Human/complications , Influenza, Human/mortality , Influenza, Human/therapy , Male , Middle Aged , Prognosis , Survival Analysis , Transplantation, Homologous
11.
Rheumatol Int ; 34(11): 1599-605, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24671503

ABSTRACT

Increased mean platelet volume (MPV) is associated with platelet reactivity and is a predictor of cardiovascular risk and unprovoked venous thromboembolism. The aim of our study was to evaluate MPV in patients with confirmed antiphospholipid antibody syndrome (APS) and to identify the correlation between the value of MPV and the recurrence of thrombosis. The studied group consists of 247 patients with a history of thrombosis and/or pregnancy loss (median age 38, range 18-66 years) classified as APS group (n = 70) or APS negative patients (n = 177) according to the updated Sapporo criteria. The control group consisted of 98 healthy subjects. MPV was significantly higher in the group of patients with clinically and laboratory confirmed APS (median 7.85, range 4.73-12.2 fl) in comparison with the controls. It was also higher than in APS negative patients (7.61, range 5.21-12.3 fl). APS patients with triple positivity for antiphospholipid antibodies with respect to Miyakis classification categories had higher MPV values than other APS patients (9.69 ± 1.85 vs. 7.29 ± 1.3 fl, p = 0.001). Recurrent thrombotic episodes were observed in 83 patients, but among the triple positive high-risk patients with APS in 80 % cases (p = 0.0046). In receiver operating characteristic curve analysis, the value of MPV level for thrombosis recurrence prediction in the APS group with sensitivity of 86 % and specificity of 82 % was 7.4 fl. In the multivariate logistic regression model, MPV above 7.4 fl (OR 3.65; 95 % CI 1.38-9.64, p = 0.009) significantly predicts thrombosis recurrence. Our results identify the value of MPV as a prognostic factor of thrombosis recurrence in patients with APS.


Subject(s)
Antiphospholipid Syndrome/complications , Mean Platelet Volume , Platelet Activation , Thrombosis/etiology , Abortion, Spontaneous/blood , Abortion, Spontaneous/etiology , Adolescent , Adult , Aged , Antiphospholipid Syndrome/blood , Antiphospholipid Syndrome/diagnosis , Area Under Curve , Biomarkers/blood , Case-Control Studies , Chi-Square Distribution , Female , Humans , Logistic Models , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Predictive Value of Tests , Pregnancy , ROC Curve , Recurrence , Risk Factors , Thrombosis/blood , Thrombosis/diagnosis , Young Adult
12.
Kardiol Pol ; 66(10): 1091-4; discussion 1095, 2008 Oct.
Article in Polish | MEDLINE | ID: mdl-19006032

ABSTRACT

A case of a 25-year-old woman with life-threatening pulmonary embolism, which occurred on fourth day after appendectomy and was safely treated with alteplase infusion. Before surgery, oral contraceptive use history, as a sole venous thromboembolic risk factor has been missed and the patient did not receive perioperative, pharmacologic antithrombotic prophylaxis. Further screening for thrombophilia was negative. This case proves that contraceptives use may create, irrespectively of the woman age, a possibility of perioperative thromboembolic complications, even for such minor procedure as appendectomy.


Subject(s)
Contraceptives, Oral, Hormonal/adverse effects , Venous Thromboembolism/chemically induced , Venous Thrombosis/chemically induced , Adult , Appendectomy , Female , Fibrinolytic Agents/administration & dosage , Humans , Infusions, Intra-Arterial , Treatment Outcome , Venous Thromboembolism/drug therapy , Venous Thrombosis/drug therapy
13.
Pol Arch Med Wewn ; 118(12): 727-33, 2008 Dec.
Article in English | MEDLINE | ID: mdl-19202951

ABSTRACT

INTRODUCTION: Acetylsalicylic acid (ASA) due to its antiplatelet action is used in ischemic stroke therapy. The platelet response to ASA shows an interindividual variation. Decreased platelet sensitivity to ASA is termed as resistance to ASA. OBJECTIVES: The aim of the study was to assess the prevalence of resistance to ASA in stroke patients and discover dependence between resistance to ASA and stroke recurrence and certain genetic and environmental factors. PATIENTS AND METHODS: 59 patients aged 22-83 years (mean age: 53) who had ischemic stroke within the period of 1 month to 10 years prior to the study were analyzed. 51 patients received ASA in a daily dose of 75 mg, and 8 in a higher dose. ASA had been taken since the stroke episode. Resistance was analyzed using the PFA-100 and optical aggregometer, with adenosine diphosphate, collagen and arachidonic acid as platelet agonists. RESULTS: Resistance to ASA in patients after stroke is observed with frequency ranging from 9% in arachidonic acid-induced aggregometry to 65% in the PFA-100. There were correlations between platelet aggregation in response to various agonists (r = 0.37-0.77, p < or = 0.005), and between collagen-induced aggregation and the PFA-100 (r = -0.33, p = 0.016). Platelet aggregation induced by arachidonic acid (r = 0.39, p = 0.029) correlated with the stroke recurrence (n = 12). ASA resistance detected in aggregometry in response to collagen was more common in patients with 807CT genotype for Ia glycoprotein (p = 0.05), and in patients with diabetes (p = 0.039). CONCLUSIONS: In patients after ischemic stroke resistance to ASA is commonly observed. In patients with diabetes or C807Tglycoprotein Ia gene CT polymorphisms this phenomenon is more frequently detected.


Subject(s)
Aspirin/administration & dosage , Brain Ischemia/drug therapy , Drug Resistance , Platelet Aggregation Inhibitors/administration & dosage , Platelet Aggregation/drug effects , Stroke/drug therapy , Adult , Aged , Aged, 80 and over , Aspirin/pharmacology , Blood Platelets/drug effects , Female , Humans , Male , Middle Aged , Platelet Aggregation Inhibitors/pharmacology , Poland , Prognosis , Risk Assessment , Treatment Outcome
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