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Clinical Laboratory Jun 2024Acute promyelocytic leukemia (APL) is a specific type of acute myeloid leukemia [1,2], the onset of the disease is insidious and the disease progresses rapidly, and...
BACKGROUND
Acute promyelocytic leukemia (APL) is a specific type of acute myeloid leukemia [1,2], the onset of the disease is insidious and the disease progresses rapidly, and failure to detect it in time or missing the best time to seek medical treatment is likely to cause secondary cerebral hemorrhage and lead to early death (ED: deaths occur in the first 30 days post diagnosis) [3-5].
METHODS
A patient with APL was rapidly identified by peripheral blood image, fibrinogen (FIB), and D-dimer within 24 hours. Finally, APL was confirmed by bone marrow cell morphology, molecular biology, and cytogenetics.
RESULTS
The presence of faggot cells with Auer rods in the peripheral blood image and the coagulation function changes abnormally at the same time. Once the above abnormal results are found, APL should be highly suspected and timely reported to the clinic for corresponding treatment.
CONCLUSIONS
APL is a critical disease, the time limit for definitive diagnosis should be calculated in hours rather than days. Peripheral blood smear microscopic examination can effectively screen out rare promyelocytes and combine with abnormal FIB and D-dimer results that are highly suspicious of APL. These methods have important clinical significance in the initial screening, early diagnosis, and reduction of early mortality due to APL.
Topics: Humans; Leukemia, Promyelocytic, Acute; Fibrin Fibrinogen Degradation Products; Male; Fibrinogen; Time Factors
PubMed: 38868893
DOI: 10.7754/Clin.Lab.2024.240116 -
Clinical Laboratory Jun 2024There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity...
BACKGROUND
There are many methods for the detection of D-dimer in clinical laboratories. Immunoturbidimetric assays are widely used because of its high sensitivity and specificity [1-3]. However, this method may be affected by the interference of rheumatoid factor (RF), heterophilic antibodies, and other unknown proteins, and its falsity will increase, thus affecting clinical diagnosis.
METHODS
This paper reports the cause analysis of a case of spurious D-dimer increase and four corresponding elimination methods: double dilution of the original specimen, detection of fibrin degradation product (FDP) level, addition of heterophilic blocking reagent, and comparison between different instruments.
RESULTS
It was confirmed that there were special antibodies in the patient's body by four methods, which had non-specific reactions with D-dimer reagents, resulting in false increases of results.
CONCLUSIONS
When the coagulation function results of patients show isolated increases in D-dimer, or the results are inconsistent with clinical symptoms, laboratory personnel should consider the possibility of interference factors, and conduct effective treatment to obtain correct test results, and thus reduce the occurrence of medical adverse events caused by inaccurate test results.
Topics: Humans; Fibrin Fibrinogen Degradation Products; False Positive Reactions; Immunoturbidimetry; Female; Male; Antibodies, Heterophile; Rheumatoid Factor
PubMed: 38868870
DOI: 10.7754/Clin.Lab.2023.231229 -
Journal of Orthopaedic Surgery and... Jun 2024The role of red blood cell (RBC) counts as potential independent risk factors for deep vein thrombosis (DVT) in patients with spinal cord injury (SCI) remains uncertain.... (Observational Study)
Observational Study
BACKGROUND
The role of red blood cell (RBC) counts as potential independent risk factors for deep vein thrombosis (DVT) in patients with spinal cord injury (SCI) remains uncertain. This study aims to clarify the associations between RBC counts and DVT incidence among this population.
METHODS
A retrospective analysis was performed on 576 patients with SCI admitted to the rehabilitation medicine department from January 1, 2017 to December 31, 2021. After exclusions, 319 patients were analyzed, among which 94 cases of DVT were identified.
RESULTS
Mode of injury, D-dimer and anticoagulant therapy were significant covariates (P < 0.05). Age, fibrinogen, D-dimer, anticoagulant therapy and American Spinal Cord Injury Association impairment scale (AIS) grades were associated with RBC counts and DVT incidence (P < 0.05). Adjusting for these factors, a 1.00 × 10^12/L increase in RBC counts correlated with a 45% decrease in DVT incidence (P = 0.042), revealing a "U" shaped relationship with a pivot at 4.56 × 10^12/L (P < 0.05).
CONCLUSION
RBC counts below 4.56 × 10^12/L serve as a protective factor against DVT, while counts above this threshold pose a risk. These findings could inform the development of DVT prevention strategies for patients with SCI, emphasizing the need for targeted monitoring and management of RBC counts.
Topics: Humans; Spinal Cord Injuries; Retrospective Studies; Venous Thrombosis; Male; Female; Incidence; Middle Aged; Adult; Risk Factors; Erythrocyte Count; Aged; Fibrin Fibrinogen Degradation Products; Anticoagulants; Time Factors
PubMed: 38867298
DOI: 10.1186/s13018-024-04838-1 -
Scientific Reports Jun 2024There remains no optimal anticoagulation protocol for continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in pediatric patients with...
There remains no optimal anticoagulation protocol for continuous renal replacement therapy (CRRT) with regional citrate anticoagulation (RCA) in pediatric patients with elevated D-dimer levels. We aimed to assess the effects of different anticoagulation strategies on the risk of CRRT filter clotting in these patients. Pediatric patients undergoing CRRT were retrospectively grouped based on pre-CRRT D-dimer levels and anticoagulant: D-RCA group (normal D-dimer, RCA only, n = 22), D+ RCA group (elevated D-dimer, RCA only, n = 50), and D+ RCA+ systemic heparin anticoagulation (SHA) group (elevated D-dimer, RCA combined with SHA, n = 55). The risk of filter clotting and incidence of bleeding were compared among the groups. Among the groups, the D+ RCA+ SHA group had the longest filter lifespan; further, the incidence of bleeding was not increased by concurrent use of low-dose heparin for anticoagulation. Moreover, concurrent heparin anticoagulation was associated with a decreased risk of filter clotting. Contrastingly, high pre-CRRT hemoglobin and D-dimer levels and post-filter ionized calcium level > 0.4 mmol/L were associated with an increased risk of filter clotting. RCA combined with low-dose heparin anticoagulation could reduce the risk of filter clotting and prolong filter lifespan without increasing the risk of bleeding in patients with elevated D-dimer levels undergoing CRRT.
Topics: Humans; Anticoagulants; Heparin; Continuous Renal Replacement Therapy; Male; Female; Citric Acid; Child; Fibrin Fibrinogen Degradation Products; Child, Preschool; Retrospective Studies; Infant; Hemorrhage; Blood Coagulation; Adolescent; Renal Replacement Therapy
PubMed: 38866989
DOI: 10.1038/s41598-024-64433-6 -
BMJ (Clinical Research Ed.) Jun 2024call for greater use of this inexpensive generic drug that can improve surgical outcomes, avoid unnecessary blood transfusion, and conserve blood stocks
call for greater use of this inexpensive generic drug that can improve surgical outcomes, avoid unnecessary blood transfusion, and conserve blood stocks
Topics: Tranexamic Acid; Humans; Antifibrinolytic Agents; Blood Loss, Surgical
PubMed: 38866414
DOI: 10.1136/bmj-2024-079444 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: The main goal is to assess the levels of comorbid diseases and examine the changes in D-dimer in hospitalized patients before and following SC enoxaparin medication. (Comparative Study)
Comparative Study
OBJECTIVE
Aim: The main goal is to assess the levels of comorbid diseases and examine the changes in D-dimer in hospitalized patients before and following SC enoxaparin medication.
PATIENTS AND METHODS
Material and Methods: At the Al-Yarmouk Teaching Hospital in Baghdad, Iraq, from October 2022 to May 2023, 86 patients who were hospitalized and had severe to critical COVID-19 infections provided data for a retrospective analysis.
RESULTS
Results: The medical records of all COVID-19 patients who were hospitalized and whose D-dimer level was greater than 0.5 mg/l and who were given enoxaparin (40 mg subcutaneously) were reviewed with the requisite authorization from the relevant authorities. The D-dimer level was assessed following therapy on the day of admission and day five after commencing enoxaparin. An examination of 86 case records revealed that persons with COVID-19 had significantly decreased D-dimer levels after taking subcutaneous enoxaparin (p-value<0.0001). The comorbidities (diabetes mellitus, hypertension) of patients who received the drug were compared.
CONCLUSION
Conclusions: Enoxaparin and other anticoagulants were utilized to treat the coagulopathy brought on by COVID-19. Low molecular weight heparin enoxaparin has demonstrated positive outcomes in the management of VTE. A decrease in D-dimer level is anticipated when COVID-19 patients are treated with subcutaneous enoxaparin, partly because decreased coagulation results in lower fibrin formation.
Topics: Humans; Enoxaparin; Fibrin Fibrinogen Degradation Products; Female; Male; COVID-19; Retrospective Studies; Middle Aged; Comorbidity; Anticoagulants; SARS-CoV-2; Adult; Iraq; Aged; COVID-19 Drug Treatment; Hospitalization
PubMed: 38865643
DOI: 10.36740/WLek202404131 -
Predictive value of D-Dimer and thromboplastin time as coagulation indicators for COVID-19 patients.Journal of Infection in Developing... May 2024Coronavirus 2019 symptoms include coagulopathy and thromboembolic risk. Using one parameter to diagnose coagulopathy has little predictive value.
INTRODUCTION
Coronavirus 2019 symptoms include coagulopathy and thromboembolic risk. Using one parameter to diagnose coagulopathy has little predictive value.
OBJECTIVE
This study will examine if D-dimer and APTT testing can predict COVID-19 severity and aid triage and manage patients.
METHODS
214 COVID-19 patients were enrolled and classified into two categories based on their respiratory manifestations; mild (126 cases) and severe (88 cases). Patient data regarding age, gender, D-Dimer level, and APTT level were collected. When both D-Dimer and APTT levels were abnormal, in this study, the patient was considered to have a coagulation disorder. Indicators of coagulation in the COVID-19 patients were collected and compared between the two groups. Chi-square (χ2) tests were used to determine the significant differences between coagulation disorders in the two groups.
RESULTS
Our findings showed that patients with coagulopathies were more likely to belong to the severe group. Within the two groups of patients, the rate of coagulation disorders was as follows: mild = 8.8 % within coagulation disorders, 4.8% within the two Groups; severe = 91.2 % within coagulation disorders, 77.8 % within the two Groups. There was a statistically significant relationship between coagulation disorder and severe COVID-19 patients compared to mild patients (p < 0.05).
CONCLUSIONS
Coagulation disorders are more likely to occur in severe COVID-19 patients. D-Dimer and APTT tests are significant indicators for predicting COVID-19 severity. Our research found an abnormal pattern of coagulation disorders and COVID-19 severity that should be considered in the COVID-19 treatment protocol.
Topics: Humans; COVID-19; Fibrin Fibrinogen Degradation Products; Male; Female; Middle Aged; Partial Thromboplastin Time; Blood Coagulation Disorders; Adult; Predictive Value of Tests; Aged; Severity of Illness Index; SARS-CoV-2
PubMed: 38865388
DOI: 10.3855/jidc.18593 -
International Journal of Systematic and... Jun 2024A Gram-stain-negative, aerobic, non-spore-forming, nonmotile, rod-shaped, and yellow-pigmented bacterium, designated strain JXAS1, was isolated from a freshwater sample...
A Gram-stain-negative, aerobic, non-spore-forming, nonmotile, rod-shaped, and yellow-pigmented bacterium, designated strain JXAS1, was isolated from a freshwater sample collected from Poyang Lake in China. Phylogenetic analysis based on 16S rRNA gene sequence revealed that the isolate belonged to the genus , being closest to DSM 6368 (98.61 %). The genome size of strain JXAS1 was 4.66 Mb with DNA G+C content 35.7 mol%. The average nucleotide identity and DNA-DNA hybridization values between strain JXAS1 and its closest relatives were below the threshold values of 95 and 70 %, respectively. The strain contained menaquinone 6 (MK-6) as the predominant menaquinone and the major polar lipids were phosphatidylethanolamine, one unidentified glycolipid, and one unidentified polar lipid. The major fatty acids (>5 %) were iso-C, summed feature 3 (C 7 and/or C 6), C, iso-C 3OH, iso-C 3OH, and summed feature 9 (iso-C 9 and/or 10-methyl C). Based on phylogenetic, genotypic, and phenotypic evidence, the isolated strain represents a new species in the genus , and the name is proposed. The type strain is JXAS1 (=GDMCC 1.1378=KCTC 62719).
Topics: Flavobacterium; Lakes; Phylogeny; China; RNA, Ribosomal, 16S; Base Composition; Fatty Acids; Vitamin K 2; DNA, Bacterial; Bacterial Typing Techniques; Sequence Analysis, DNA; Nucleic Acid Hybridization; Phosphatidylethanolamines; Glycolipids; Phospholipids
PubMed: 38865183
DOI: 10.1099/ijsem.0.006416 -
International Journal of Systematic and... Jun 2024Two bacteria, UG2_1 and UG2_2, were isolated from the gill tissues of the mangrove fiddler crab collected on the east coast of the Red Sea (Thuwal, Saudi Arabia). The...
Two bacteria, UG2_1 and UG2_2, were isolated from the gill tissues of the mangrove fiddler crab collected on the east coast of the Red Sea (Thuwal, Saudi Arabia). The cells are Gram-negative, rod-shaped, orange-pigmented, motile by gliding with no flagella, strictly aerobic, and grow at 20-37 °C (optimum, 28-35 °C), at pH 5.0-9.0 (optimum, pH 6.0-7.0), and with 1-11 % (w/v) NaCl (optimum, 2-4 %). They were positive for oxidase and catalase activity. Phylogenetic analysis based on 16S rRNA gene sequences indicated that isolates UG2_1 and UG2_2 belong to the genus , showing the highest similarity to HN-E26 (99.4 %). Phylogenomic analysis based on the whole genomes, independently using 49 and 120 concatenated genes, showed that strains UG2_1 and UG2_2 formed a monophyletic lineage in a different cluster from other type strain species within the genus . The genome sizes were 3.08 and 3.07 Mbp for UG2_1 and UG2_2, respectively, with a G+C content of 33.8 mol% for both strains. Values of average nucleotide identity and digital DNA-DNA hybridization between the strains and closely related species were 91.0 and 43.5 %, respectively. Chemotaxonomic analysis indicated that both strains had iso-C and iso-C G as dominant fatty acids, and the primary respiratory quinone was identified as MK-6. The major polar lipids comprised phosphatidylethanolamine, one unidentified glycolipid, one unidentified phospholipid, two unidentified aminolipids, and four unidentified lipids. Based on phylogenetic, phylogenomic, genome relatedness, phenotypic, and chemotaxonomical data, the two isolates represent a novel species within the genus , with the proposed name sp. nov., and the type strain UG2_1 (=KCTC 102158=DSM 117025).
Topics: Phylogeny; RNA, Ribosomal, 16S; Fatty Acids; Base Composition; DNA, Bacterial; Bacterial Typing Techniques; Indian Ocean; Animals; Gills; Sequence Analysis, DNA; Nucleic Acid Hybridization; Brachyura; Saudi Arabia; Wetlands; Vitamin K 2; Phospholipids
PubMed: 38865172
DOI: 10.1099/ijsem.0.006415 -
Bioprocess and Biosystems Engineering Jul 2024Menaquinone-7 (MK-7), a vital vitamin with numerous health benefits, is synthesized and secreted extracellularly by the formation of biofilm, dominantly in Bacillus...
Menaquinone-7 (MK-7), a vital vitamin with numerous health benefits, is synthesized and secreted extracellularly by the formation of biofilm, dominantly in Bacillus strains. Our team developed an innovative biofilm reactor utilizing Bacillus subtilis natto cells to foster biofilm growth on plastic composite supports to produce MK-7. Continuous fermentation in biofilm reactors offers a promising strategy for achieving sustainable and efficient production of Menaquinone-7 (MK-7). Unlike conventional batch fermentation, continuous biofilm reactors maintain a steady state of operation, which reduces resource consumption and waste generation, contributing to sustainability. By optimizing fermentation conditions, MK-7 production was significantly enhanced in this study, demonstrating the potential for sustainable industrial-scale production. To determine the optimal operational parameters, various dilution rates were tested. These rates were selected based on their potential to enhance nutrient supply and biofilm stability, thereby improving MK-7 production. By carefully considering the fermentation conditions and systematically varying the dilution rates, MK-7 production was significantly enhanced during continuous fermentation. The MK-7 productivity was found to increase from 0.12 mg/L/h to 0.33 mg/L/h with a dilution rate increment from 0.007 to 0.042 h). This range was chosen to explore the impact of various nutrient supply rates on MK-7 production and to identify the optimal conditions for maximizing productivity. However, a further increase in the dilution rate to 0.084 h led to reduced productivity at approximately 0.16 mg/L/h, likely due to insufficient retention time for effective biofilm formation. Consequently, a dilution rate of 0.042 h exhibited the highest productivity of 0.33 mg/L/h, outperforming all investigated dilution rates and demonstrating the critical balance between nutrient supply and retention time in continuous fermentation. These findings validate the feasibility of operating continuous fermentation at a 0.084 h dilution rate, corresponding to a 48 h retention time, to achieve the highest MK-7 productivity compared to conventional batch fermentation. The significant advancements achieved in enhancing Menaquinone-7 (MK-7) productivity through continuous fermentation at optimal dilution rates in the present work indicate promising prospects for even greater efficiency and sustainability in MK-7 production through future developments.
Topics: Biofilms; Vitamin K 2; Bioreactors; Bacillus subtilis; Fermentation
PubMed: 38864863
DOI: 10.1007/s00449-024-03040-1