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[PMID]:27771726
[Au] Autor:Obi AT; Andraska E; Kanthi Y; Luke CE; Elfline M; Madathilparambil S; Siahaan TJ; Jaffer FA; Wakefield TW; Raghavendran K; Henke PK
[Ad] Endereço:Conrad Jobst Vascular Research Laboratory, University of Michigan Medical School, Ann Arbor, Mich., USA.
[Ti] Título:Gram-Negative Pneumonia Alters Large-Vein Cell-Adhesion Molecule Profile and Potentiates Experimental Stasis Venous Thrombosis.
[So] Source:J Vasc Res;53(3-4):186-195, 2016.
[Is] ISSN:1423-0135
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND/AIMS: Pneumonia is a significant risk factor for the development of venous thrombosis (VT). Cell-adhesion molecules (CAMs) are linked to the pathogenesis of both pneumonia and VT. We hypothesized that remote infection would confer a prothrombogenic milieu via systemic elevation of CAMs. METHODS: Lung injury was induced in wild-type (C57BL/6) mice by lung contusion or intratracheal inoculation with Klebsiella pneumoniae or saline controls. K. pneumoniae-treated mice and controls additionally underwent inferior vena cava (IVC) ligation to generate VT. RESULTS: Lung-contusion mice demonstrated no increase in E-selectin or P-selectin whereas mice infected with K. pneumoniae demonstrated increased circulating P-selectin, ICAM-1, VCAM-1 and thrombin-antithrombin (TAT) complexes. Mice with pneumonia formed VT 3 times larger than controls, demonstrated significantly more upregulation of vein-wall and systemic CAMs, and formed erythrocyte-rich thrombi. CONCLUSION: Elevated CAM expression was identified in mice with pneumonia, but not lung contusion, indicating that the type of inflammatory stimulus and the presence of infection drive the vein-wall response. Elevation of CAMs was associated with amplified VT and may represent an alternate mechanism by which to target the prevention of VT.
[Mh] Termos MeSH primário: Moléculas de Adesão Celular/sangue
Infecções por Klebsiella/complicações
Klebsiella pneumoniae/patogenicidade
Pneumonia Bacteriana/complicações
Veia Cava Inferior/metabolismo
Trombose Venosa/etiologia
[Mh] Termos MeSH secundário: Lesão Pulmonar Aguda/sangue
Lesão Pulmonar Aguda/complicações
Animais
Antitrombina III
Moléculas de Adesão Celular/antagonistas & inibidores
Modelos Animais de Doenças
Fibrinolíticos/farmacologia
Molécula 1 de Adesão Intercelular/sangue
Infecções por Klebsiella/sangue
Infecções por Klebsiella/tratamento farmacológico
Infecções por Klebsiella/microbiologia
Ligadura
Masculino
Camundongos Endogâmicos C57BL
Selectina-P/sangue
Peptídeo Hidrolases/sangue
Pneumonia Bacteriana/sangue
Pneumonia Bacteriana/tratamento farmacológico
Pneumonia Bacteriana/microbiologia
Regulação para Cima
Molécula 1 de Adesão de Célula Vascular/sangue
Veia Cava Inferior/cirurgia
Trombose Venosa/sangue
Trombose Venosa/microbiologia
Trombose Venosa/prevenção & controle
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cell Adhesion Molecules); 0 (Fibrinolytic Agents); 0 (Icam1 protein, mouse); 0 (P-Selectin); 0 (Vascular Cell Adhesion Molecule-1); 0 (antithrombin III-protease complex); 126547-89-5 (Intercellular Adhesion Molecule-1); 9000-94-6 (Antithrombin III); EC 3.4.- (Peptide Hydrolases)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28409836
[Au] Autor:Wang Y; Zhang S; Luo L; Norström E; Braun OÖ; Mörgelin M; Thorlacius H
[Ad] Endereço:Department of Clinical Sciences, Section for Surgery, Lund University, Malmö, Sweden.
[Ti] Título:Platelet-derived microparticles regulates thrombin generation via phophatidylserine in abdominal sepsis.
[So] Source:J Cell Physiol;233(2):1051-1060, 2018 Feb.
[Is] ISSN:1097-4652
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sepsis is associated with dysfunctional coagulation. Recent data suggest that platelets play a role in sepsis by promoting neutrophil accumulation. Herein, we show that cecal ligation and puncture (CLP) triggered systemic inflammation, which is characterized by formation of IL-6 and CXC chemokines as well as neutrophil accumulation in the lung. Platelet depletion decreased neutrophil accumulation, IL-6, and CXC chemokines formation in septic lungs. Depletion of platelets increased peak thrombin formation and total thrombin generation (TG) in plasma from septic animals. CLP elevated circulating levels of platelet-derived microparticles (PMPs). In vitro generated PMPs were a potent inducer of TG. Interestingly, in vitro wild-type recombinant annexin V abolished PMP-induced thrombin formation whereas a mutant annexin V protein, which does not bind to phosphatidylserine (PS), had no effect. Administration of wild-type, but not mutant annexin V, significantly inhibited thrombin formation in septic animals. Moreover, CLP-induced formation of thrombin-antithrombin complexes were reduced in platelet-depleted mice and in animals pretreated with annexin V. PMP-induced TG attenuated in FXII- and FVII-deficient plasma. These findings suggest that sepsis-induced TG is dependent on platelets. Moreover, PMPs formed in sepsis are a potent inducer of TG via PS exposure, and activation of both the intrinsic and extrinsic pathway of coagulation. In conclusion, these observations suggest that PMPs and PS play an important role in dysfunctional coagulation in abdominal sepsis.
[Mh] Termos MeSH primário: Coagulação Sanguínea
Plaquetas/metabolismo
Micropartículas Derivadas de Células/metabolismo
Fosfatidilserinas/sangue
Sepse/sangue
Trombina/metabolismo
[Mh] Termos MeSH secundário: Animais
Anexina A5/sangue
Antitrombina III
Plaquetas/imunologia
Plaquetas/microbiologia
Plaquetas/ultraestrutura
Micropartículas Derivadas de Células/imunologia
Micropartículas Derivadas de Células/microbiologia
Micropartículas Derivadas de Células/ultraestrutura
Quimiocinas CXC/metabolismo
Modelos Animais de Doenças
Inflamação/sangue
Inflamação/imunologia
Inflamação/microbiologia
Interleucina-6/metabolismo
Pulmão/imunologia
Pulmão/metabolismo
Pulmão/microbiologia
Masculino
Camundongos Endogâmicos C57BL
Infiltração de Neutrófilos
Peptídeo Hidrolases/sangue
Sepse/imunologia
Sepse/microbiologia
Sepse/patologia
Transdução de Sinais
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Annexin A5); 0 (Chemokines, CXC); 0 (Interleukin-6); 0 (Phosphatidylserines); 0 (antithrombin III-protease complex); 0 (interleukin-6, mouse); 9000-94-6 (Antithrombin III); EC 3.4.- (Peptide Hydrolases); EC 3.4.21.5 (Thrombin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170415
[St] Status:MEDLINE
[do] DOI:10.1002/jcp.25959


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[PMID]:29040284
[Au] Autor:Lee SY; Kim EK; Kim MS; Shin SH; Chang H; Jang SY; Kim HJ; Kim DK
[Ad] Endereço:Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
[Ti] Título:The prevalence and clinical manifestation of hereditary thrombophilia in Korean patients with unprovoked venous thromboembolisms.
[So] Source:PLoS One;12(10):e0185785, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hereditary thrombophilia (HT) is a genetic predisposition to thrombosis. Asian mutation spectrum of HT is different from Western ones. We investigated the incidence and clinical characteristics of HT in Korean patients with unprovoked venous thromboembolism (VTE). METHODS: Among 369 consecutive patients with thromboembolic event who underwent thrombophilia tests, we enrolled 222 patients diagnosed with unprovoked VTE. The presence of HT was confirmed by DNA sequencing of the genes that cause deficits in natural anticoagulants (NAs). Median follow-up duration was 40±38 months. RESULTS: Among the 222 patients with unprovoked VTE, 66 (29.7%) demonstrated decreased NA level, and 33 (14.9%) were finally confirmed to have HT in a genetic molecular test. Antithrombin III deficiency (6.3%) was most frequently detected, followed by protein C deficiency (5.4%), protein S deficiency (1.8%), and dysplasminogenemia (1.4%). The HT group was significantly younger (37 [32-50] vs. 52 [43-65] years; P < 0.001) and had a higher proportion of male (69.7% vs. 47%; P = 0.013), more previous VTE events (57.6% vs. 31.7%; P = 0.004), and a greater family history of VTE (43.8% vs. 1.9%; P < 0.001) than the non-HT group. Age <45 years and a family history of VTE were independent predictors for unprovoked VTE with HT (odds ratio, 9.435 [2.45-36.35]; P = 0.001 and 92.667 [14.95-574.29]; P < 0.001). CONCLUSIONS: About 15% of patients with unprovoked VTE had HT. A positive family history of VTE and age <45 years were independent predictors for unprovoked VTE caused by HT.
[Mh] Termos MeSH primário: Deficiência de Antitrombina III/fisiopatologia
Conjuntivite/fisiopatologia
Plasminogênio/deficiência
Deficiência de Proteína C/fisiopatologia
Deficiência de Proteína S/fisiopatologia
Dermatopatias Genéticas/fisiopatologia
Trombofilia/fisiopatologia
Tromboembolia Venosa/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Antitrombina III/genética
Deficiência de Antitrombina III/complicações
Deficiência de Antitrombina III/diagnóstico
Deficiência de Antitrombina III/genética
Conjuntivite/complicações
Conjuntivite/diagnóstico
Conjuntivite/genética
Feminino
Expressão Gênica
Seres Humanos
Masculino
Meia-Idade
Plasminogênio/genética
Proteína C/genética
Deficiência de Proteína C/complicações
Deficiência de Proteína C/diagnóstico
Deficiência de Proteína C/genética
Proteína S/genética
Deficiência de Proteína S/complicações
Deficiência de Proteína S/diagnóstico
Deficiência de Proteína S/genética
República da Coreia
Estudos Retrospectivos
Análise de Sequência de DNA
Dermatopatias Genéticas/complicações
Dermatopatias Genéticas/diagnóstico
Dermatopatias Genéticas/genética
Trombofilia/diagnóstico
Trombofilia/etiologia
Trombofilia/genética
Tromboembolia Venosa/diagnóstico
Tromboembolia Venosa/etiologia
Tromboembolia Venosa/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Protein C); 0 (Protein S); 9000-94-6 (Antithrombin III); 9001-91-6 (Plasminogen)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185785


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[PMID]:28986431
[Au] Autor:Verhamme IM
[Ad] Endereço:From the Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee 37232 Ingrid.verhamme@vanderbilt.edu.
[Ti] Título:A novel antithrombin domain dictates the journey's end of a proteinase.
[So] Source:J Biol Chem;292(40):16521-16522, 2017 10 06.
[Is] ISSN:1083-351X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Antithrombin (AT) is an anticoagulant serpin that irreversibly inactivates the clotting proteinases factor Xa and thrombin by forming covalent complexes with them. Mutations in its critical domains, such as those that impair the conformational rearrangement required for proteinase inactivation, increase the risk of venous thrombosis. Águila characterize for the first time the destabilizing effects of mutations in the region of AT that makes contact with the proteinase in the final acyl-enzyme complex. Their work adds new insight into the unique structural intricacies of the inhibitory mechanism.
[Mh] Termos MeSH primário: Antitrombinas/química
Heparina/química
[Mh] Termos MeSH secundário: Antitrombina III
Fator Xa
Seres Humanos
Peptídeo Hidrolases
Trombina
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Antithrombins); 9000-94-6 (Antithrombin III); 9005-49-6 (Heparin); EC 3.4.- (Peptide Hydrolases); EC 3.4.21.5 (Thrombin); EC 3.4.21.6 (Factor Xa)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171025
[Lr] Data última revisão:
171025
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE
[do] DOI:10.1074/jbc.H117.787325


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[PMID]:28691885
[Au] Autor:Pasi KJ; Rangarajan S; Georgiev P; Mant T; Creagh MD; Lissitchkov T; Bevan D; Austin S; Hay CR; Hegemann I; Kazmi R; Chowdary P; Gercheva-Kyuchukova L; Mamonov V; Timofeeva M; Soh CH; Garg P; Vaishnaw A; Akinc A; Sørensen B; Ragni MV
[Ad] Endereço:From the Royal London Haemophilia Centre, Barts and the London School of Medicine and Dentistry (K.J.P.), National Institute for Health Research (NIHR) Biomedical Research Centre (T.M.), Guy's and St. Thomas' NHS Foundation Trust, King's College London (D.B.), St. George's Healthcare NHS Trust Haemo
[Ti] Título:Targeting of Antithrombin in Hemophilia A or B with RNAi Therapy.
[So] Source:N Engl J Med;377(9):819-828, 2017 08 31.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current hemophilia treatment involves frequent intravenous infusions of clotting factors, which is associated with variable hemostatic protection, a high treatment burden, and a risk of the development of inhibitory alloantibodies. Fitusiran, an investigational RNA interference (RNAi) therapy that targets antithrombin (encoded by SERPINC1), is in development to address these and other limitations. METHODS: In this phase 1 dose-escalation study, we enrolled 4 healthy volunteers and 25 participants with moderate or severe hemophilia A or B who did not have inhibitory alloantibodies. Healthy volunteers received a single subcutaneous injection of fitusiran (at a dose of 0.03 mg per kilogram of body weight) or placebo. The participants with hemophilia received three injections of fitusiran administered either once weekly (at a dose of 0.015, 0.045, or 0.075 mg per kilogram) or once monthly (at a dose of 0.225, 0.45, 0.9, or 1.8 mg per kilogram or a fixed dose of 80 mg). The study objectives were to assess the pharmacokinetic and pharmacodynamic characteristics and safety of fitusiran. RESULTS: No thromboembolic events were observed during the study. The most common adverse events were mild injection-site reactions. Plasma levels of fitusiran increased in a dose-dependent manner and showed no accumulation with repeated administration. The monthly regimen induced a dose-dependent mean maximum antithrombin reduction of 70 to 89% from baseline. A reduction in the antithrombin level of more than 75% from baseline resulted in median peak thrombin values at the lower end of the range observed in healthy participants. CONCLUSIONS: Once-monthly subcutaneous administration of fitusiran resulted in dose-dependent lowering of the antithrombin level and increased thrombin generation in participants with hemophilia A or B who did not have inhibitory alloantibodies. (Funded by Alnylam Pharmaceuticals; ClinicalTrials.gov number, NCT02035605 .).
[Mh] Termos MeSH primário: Antitrombina III/antagonistas & inibidores
Hemofilia A/terapia
Hemofilia B/terapia
Terapêutica com RNAi
[Mh] Termos MeSH secundário: Adulto
Antitrombinas/sangue
Relação Dose-Resposta a Droga
Voluntários Saudáveis
Hemofilia A/sangue
Hemofilia B/sangue
Seres Humanos
Injeções Subcutâneas
Masculino
Meia-Idade
Método Simples-Cego
Trombina/biossíntese
Adulto Jovem
[Pt] Tipo de publicação:CLINICAL TRIAL, PHASE I; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antithrombins); 0 (SERPINC1 protein, human); 9000-94-6 (Antithrombin III); EC 3.4.21.5 (Thrombin)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170711
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMoa1616569


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[PMID]:28637551
[Au] Autor:Ang D; Kurek S; McKenney M; Norwood S; Kimbrell B; Barquist E; Liu H; O'Dell A; Ziglar M; Hurst J
[Ti] Título:Outcomes of Geriatric Trauma Patients on Preinjury Anticoagulation: A Multicenter Study.
[So] Source:Am Surg;83(6):527-535, 2017 Jun 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Outpatient anticoagulation in the geriatric trauma patient is a challenging clinical problem. The aim of this study is to determine clinical outcomes associated with class of preinjury anticoagulants (PA) used by this population. This is a multicenter retrospective cohort study among four Level II trauma centers. A total of 1642 patients were evaluated; 684 patients were on anticoagulation and 958 patients were not. Patients on PA were compared with those who were not. Drug classes were divided into thromboxane A2 inhibitors, vitamin K factor-dependent inhibitors, antithrombin III activation, platelet P2Y12 inhibitors, and thrombin inhibitors. Multivariate regression was used to adjust for age, gender, race, mechanism of injury, and Injury Severity Score. No single or combination of anticoagulation agents had a significant association with mortality; however, there were positive trends toward increased mortality were noted for all antiplatelet groups involving thromboxane A2 inhibitors and platelet P2Y12 inhibitors classes. The likelihood of complications was significantly higher with platelet P2Y12 inhibitors adjusted odds ratio (aOR) 2.39 [95% confidence interval (CI) 1.32, 4.3]. The likelihood of blood transfusion was increased with vitamin K inhibitors aOR 2.89 (95% CI 1.3, 6.5), P2Y12 inhibitors aOR 2.76 (95% CI 1.12, 6.76), and combined thromboxane A2 and P2Y12 inhibitors aOR 2.89 (95% CI 1.13, 7.46). P2Y12 inhibitors were also more likely associated with traumatic brain injury aOR 2.16 (95% CI 1.01, 4.6). All classes of PA were associated with solid organ injury. There were no significant differences in the use of antiplatelet agents between patients with major indications for PA and those without major indications. Geriatric trauma patients on outpatient anticoagulants have a higher likelihood of developing complications, packed red blood cell transfusions, traumatic brain injury, and solid organ injury. Attention should be paid to patients on platelet P2Y12 inhibitors, vitamin K inhibitors, and thromboxane A2 inhibitor agents combined with platelet P2Y12 inhibitors. Opportunities exist to address the use of antiplatelet agents among patients without major indications to improve patient outcomes.
[Mh] Termos MeSH primário: Envelhecimento
Anticoagulantes/administração & dosagem
Geriatria
Pacientes Internados
Centros de Traumatologia
Ferimentos e Lesões/tratamento farmacológico
[Mh] Termos MeSH secundário: Idoso
Anticoagulantes/efeitos adversos
Antitrombina III/administração & dosagem
Lesões Encefálicas/tratamento farmacológico
Feminino
Florida
Avaliação Geriátrica
Hemostáticos/antagonistas & inibidores
Seres Humanos
Masculino
Pacientes Ambulatoriais
Inibidores da Agregação de Plaquetas/administração & dosagem
Antagonistas do Receptor Purinérgico P2Y/administração & dosagem
Estudos Retrospectivos
Fatores de Risco
Trombina/antagonistas & inibidores
Tromboxano-A Sintase/antagonistas & inibidores
Resultado do Tratamento
Vitamina K/antagonistas & inibidores
Vitaminas/antagonistas & inibidores
Ferimentos e Lesões/diagnóstico
Ferimentos e Lesões/mortalidade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Anticoagulants); 0 (Hemostatics); 0 (Platelet Aggregation Inhibitors); 0 (Purinergic P2Y Receptor Antagonists); 0 (Vitamins); 12001-79-5 (Vitamin K); 9000-94-6 (Antithrombin III); EC 3.4.21.5 (Thrombin); EC 5.3.99.5 (Thromboxane-A Synthase)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170623
[St] Status:MEDLINE


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[PMID]:28424376
[Au] Autor:Lu Z; Wang F; Liang M
[Ad] Endereço:Department of Nephrology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
[Ti] Título:/Antithrombin III in kidney-related diseases.
[So] Source:Clin Sci (Lond);131(9):823-831, 2017 May 01.
[Is] ISSN:1470-8736
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The gene encodes a serine protease inhibitor named antithrombin III (ATIII). This protease demonstrates both anticoagulant and anti-inflammatory action. ATIII is the most important coagulation factor inhibitor, and even minor changes in ATIII can significantly alter the risk of thromboembolism. ATIII can also suppress inflammation via a coagulation-dependent or -independent effect. Moreover, apart from ATIII deficiency, ATIII and its gene may also be related to many diseases (e.g. hypertension, kidney diseases). The present review summarizes how ATIII affects the progress of kidney disease and its mechanism. Further studies are required to investigate how ATIII affects renal function and the treatment.
[Mh] Termos MeSH primário: Deficiência de Antitrombina III/metabolismo
Antitrombina III/metabolismo
Nefropatias/metabolismo
Tromboembolia/metabolismo
[Mh] Termos MeSH secundário: Antitrombina III/genética
Antitrombina III/uso terapêutico
Deficiência de Antitrombina III/genética
Coagulação Sanguínea/efeitos dos fármacos
Seres Humanos
Inflamação/genética
Inflamação/metabolismo
Inflamação/prevenção & controle
Nefropatias/genética
Modelos Biológicos
Fatores de Risco
Transdução de Sinais
Tromboembolia/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (SERPINC1 protein, human); 9000-94-6 (Antithrombin III)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170522
[Lr] Data última revisão:
170522
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1042/CS20160669


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[PMID]:28418276
[Au] Autor:Lee SY; Niikura T; Iwakura T; Sakai Y; Kuroda R; Kurosaka M
[Ad] Endereço:1 Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
[Ti] Título:Thrombin-antithrombin III complex tests.
[So] Source:J Orthop Surg (Hong Kong);25(1):170840616684501, 2017 Jan 01.
[Is] ISSN:2309-4990
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Patients with fractures of the pelvis and/or lower extremities are at a high risk of developing postoperative venous thromboembolism (VTE). The purpose of this study was to determine whether the thrombin-antithrombin III complex (TAT) tests could be used for postoperative screening of VTE in patients with lower limb or pelvic fractures. METHODS: We enrolled 133 patients who underwent surgical treatment for fracture of the pelvis or lower extremities. TAT and D-dimer levels were compared in patients with and without VTE. Receiver operating characteristic (ROC) curve analysis was done and the appropriate TAT and D-dimer cutoff levels were determined for VTE screening. RESULTS: VTE was diagnosed in 41 patients (30.8%). Patients with VTE had significantly higher levels of TAT and D-dimer on postoperative days 1, 3, and 7 than those without VTE, respectively. ROC curve analysis suggested that TAT test at postoperative day 7 had the highest accuracy for predicting postoperative VTE. With the optimal cutoff TAT level of 3.0 ng/mL, sensitivity and specificity were 93.3% and 70.1%, respectively. With the optimal cutoff D-dimer level of 7.4 µg/mL, sensitivity and specificity were 93.3% and 57.0%, respectively. CONCLUSION: TAT levels measured at postoperative day 7 could be the most useful parameter for screening postoperative VTE. TAT can be used as a screening tool for screening postoperative VTE in patients with lower limb and pelvic fractures.
[Mh] Termos MeSH primário: Ossos da Extremidade Inferior/lesões
Fixação Interna de Fraturas/efeitos adversos
Fraturas Ósseas/cirurgia
Peptídeo Hidrolases/sangue
Complicações Pós-Operatórias/sangue
Tromboembolia Venosa/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Antitrombina III
Estudos de Casos e Controles
Feminino
Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo
Fraturas Ósseas/sangue
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/etiologia
Sensibilidade e Especificidade
Tromboembolia Venosa/diagnóstico
Tromboembolia Venosa/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrin Fibrinogen Degradation Products); 0 (antithrombin III-protease complex); 0 (fibrin fragment D); 9000-94-6 (Antithrombin III); EC 3.4.- (Peptide Hydrolases)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1177/0170840616684501


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[PMID]:28406940
[Au] Autor:Pereyra D; Offensperger F; Klinglmueller F; Haegele S; Oehlberger L; Gruenberger T; Brostjan C; Starlinger P
[Ad] Endereço:Department of Surgery, Medical University of Vienna, General Hospital, Vienna, Austria.
[Ti] Título:Early prediction of postoperative liver dysfunction and clinical outcome using antithrombin III-activity.
[So] Source:PLoS One;12(4):e0175359, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND AIMS: Antithrombin III (ATIII) has been reported to be associated with liver pathologies and was shown to predict outcome in patients undergoing liver resection for hepatocellular carcinoma. We now aimed to assess whether perioperative ATIII-activity could predict postoperative outcome in patients without underlying liver disease, as well as in a routine clinical setting of patients undergoing hepatic resection. METHODS: ATIII-activity was evaluated preoperatively and on the first (POD1) and fifth day after liver resection in a retrospective evaluation cohort of 228 colorectal cancer patients with liver metastasis (mCRC). We further aimed to prospectively validate our results in a set of 177 consecutive patients undergoing hepatic resection. RESULTS: Patients developing postoperative liver dysfunction (LD) had a more pronounced postoperative decrease in ATIII-activity (P<0.001). ATIII-activity on POD1 significantly predicted postoperative LD (P<0.001, AUC = 84.4%) and remained independent upon multivariable analysis. A cut-off value of 61.5% ATIII-activity was determined using ROC analysis. This cut-off was vital to identify high-risk patients for postoperative LD, morbidity, severe morbidity and mortality (P<0.001, respectively) with a highly accurate negative predictive value of 97%, which could be confirmed for LD (P<0.001) and mortality (P = 0.014) in our independent validation cohort. Further, mCRC patients below our cut-off suffered from a significantly decreased overall survival (OS) at 1 and 3 years after surgery (P = 0.011, P = 0.025). CONCLUSIONS: The routine laboratory parameter ATIII-activity on POD1 independently predicted postoperative LD and was associated with clinical outcome. Patients with a postoperative ATIII-activity <61.5% might benefit from close monitoring and timely initiation of supportive therapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT01700231.
[Mh] Termos MeSH primário: Antitrombina III/metabolismo
Carcinoma Hepatocelular
Neoplasias Colorretais
Falência Hepática
Neoplasias Hepáticas
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Carcinoma Hepatocelular/sangue
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/cirurgia
Neoplasias Colorretais/sangue
Neoplasias Colorretais/mortalidade
Neoplasias Colorretais/cirurgia
Intervalo Livre de Doença
Feminino
Seguimentos
Seres Humanos
Falência Hepática/sangue
Falência Hepática/etiologia
Falência Hepática/mortalidade
Neoplasias Hepáticas/sangue
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/secundário
Neoplasias Hepáticas/cirurgia
Masculino
Meia-Idade
Metástase Neoplásica
Complicações Pós-Operatórias/sangue
Complicações Pós-Operatórias/mortalidade
Valor Preditivo dos Testes
Estudos Retrospectivos
Taxa de Sobrevida
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
9000-94-6 (Antithrombin III)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170504
[Lr] Data última revisão:
170504
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0175359


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[PMID]:28367083
[Au] Autor:Lin CH; Liao CC; Huang CH; Tung YT; Chang HC; Hsu MC; Huang CC
[Ad] Endereço:Physical Education Office, Yuan Ze University, Taoyuan 32003, Taiwan.
[Ti] Título:Proteomics Analysis to Identify and Characterize the Biomarkers and Physical Activities of Non-Frail and Frail Older Adults.
[So] Source:Int J Med Sci;14(3):231-239, 2017.
[Is] ISSN:1449-1907
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:Globally, the proportion of older adults is increasing. Older people face chronic conditions such as sarcopenia and functional decline, which are often associated with disability and frailty. Proteomics assay of potential serum biomarkers of frailty in older adults. Older adults were divided into non-frail and frail groups ( = 6 each; 3 males in each group) in accordance with the Chinese-Canadian Study of Health and Aging Clinical Frailty Scale. Adults were measured for grip power and the 6-min walk test for physical activity, and venous blood was sampled after adults fasted for 8 h. Ultra-high-performance liquid chromatography-tandem mass spectrometry was used for proteomics assay. The groups were compared for levels of biomarkers by test and Pearson correlation analysis. Non-frail and frail subjects had mean age 77.5±0.4 and 77.7±1.6 years, mean height 160.5±1.3 and 156.6±2.9 cm and mean weight 62.5±1.2 and 62.8±2.9 kg, respectively. Physical activity level was lower for frail than non-frail subjects (grip power: 13.8±0.4 26.1±1.2 kg; 6-min walk test: 215.2±17.2 438.3±17.2 m). Among 226 proteins detected, for 31, serum levels were significantly higher for frail than non-frail subjects; serum levels of Ig kappa chain V-III region WOL, COX7A2, and albumin were lower. The serum levels of ANGT, KG and AT were 2.05-, 1.76- and 2.22-fold lower (all < 0.05; Figure 1A, 2A and 3A) for non-frail than frail subjects and were highly correlated with grip power (Figure 1B, 2B and 3B). Our study found that ANGT, KG and AT levels are known to increase with aging, so degenerated vascular function might be associated with frailty. In total, 226 proteins were revealed proteomics assay; levels of angiotensinogen (ANGT), kininogen-1 (KG) and antithrombin III (AT) were higher in frail than non-frail subjects (11.26±2.21 5.09±0.74; 18.42±1.36 11.64±1.36; 22.23±1.64 9.52±0.95, respectively, < 0.05). These 3 factors were highly correlated with grip power ( < 0.05), with higher correlations between grip power and serum levels of ANGT (r = -0.89), KG (r = -0.90), and AT (r = -0.84). In conclusion, this is the first study to demonstrate a serum proteomic profile characteristic of frailty in older adults. Serum ANGT, KG and AT levels could be potential biomarkers for monitoring the development and progression of frailty in older adults.
[Mh] Termos MeSH primário: Envelhecimento/sangue
Biomarcadores/sangue
Idoso Fragilizado
Proteômica
Sarcopenia/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Envelhecimento/patologia
Angiotensinogênio/sangue
Antitrombina III/metabolismo
Exercício
Feminino
Força da Mão/fisiologia
Seres Humanos
Cininogênios/sangue
Masculino
Sarcopenia/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (Kininogens); 11002-13-4 (Angiotensinogen); 9000-94-6 (Antithrombin III)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170717
[Lr] Data última revisão:
170717
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.7150/ijms.17627



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