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Medicine Jun 2024The aim was to investigate the independent risk factors for lower extremity deep vein thrombosis (DVT) after total knee arthroplasty, and to establish a nomogram... (Observational Study)
Observational Study
The aim was to investigate the independent risk factors for lower extremity deep vein thrombosis (DVT) after total knee arthroplasty, and to establish a nomogram prediction model accordingly. Data were collected from total knee replacement patients from January 2022 to December 2023 in our hospital. Unifactorial and multifactorial logistic regression analyses were used to determine the independent risk factors for lower extremity DVT after total knee arthroplasty and to establish the corresponding nomogram. The receiver operating characteristic curves were plotted and the area under the curve was calculated, and the calibration curves and decision curves were plotted to evaluate the model performance. A total of 652 patients with total knee arthroplasty were included in the study, and 142 patients after total knee arthroplasty developed deep veins in the lower extremities, with an incidence rate of 21.78%. After univariate and multivariate logistic regression analyses, a total of 5 variables were identified as independent risk factors for lower extremity DVT after total knee arthroplasty: age > 60 years (OR: 1.70; 95% CI: 1.23-3.91), obesity (OR: 1.51; 95% CI: 1.10-1.96), diabetes mellitus (OR: 1.80; 95% CI: 1.23-2.46), D-dimer > 0.5 mg/L (OR: 1.47; 95% CI: 1.07-1.78), and prolonged postoperative bed rest (OR: 1.64; 95% CI: 1.15-3.44). the nomogram constructed in this study for lower extremity DVT after total knee arthroplasty has good predictive accuracy, which helps physicians to intervene in advance in patients at high risk of lower extremity DVT after total knee arthroplasty.
Topics: Humans; Arthroplasty, Replacement, Knee; Female; Male; Venous Thrombosis; Middle Aged; Nomograms; Risk Factors; Aged; Lower Extremity; Postoperative Complications; Fibrin Fibrinogen Degradation Products; ROC Curve; Retrospective Studies; Logistic Models; Age Factors; Incidence
PubMed: 38875414
DOI: 10.1097/MD.0000000000038517 -
Medical Science Monitor : International... Jun 2024BACKGROUND This prospective study from a single center aimed to compare the perioperative blood loss (PBL) in 79 patients with intertrochanteric fractures (IF) treated... (Randomized Controlled Trial)
Randomized Controlled Trial
Perioperative Administration of Tranexamic Acid and Low Molecular Weight Heparin for Enhanced Blood Management in Intertrochanteric Fractures: A Randomized Controlled Study.
BACKGROUND This prospective study from a single center aimed to compare the perioperative blood loss (PBL) in 79 patients with intertrochanteric fractures (IF) treated with intramedullary nailing (IMN) using 3 regimens of combined tranexamic acid (TXA) and low molecular weight heparin (LMWH), proposing a novel therapy of 4-dose TXA. MATERIAL AND METHODS We recruited 79 patients and randomly divided them into 3 groups. The 4-dose TXA group (22 patients) received 1.0 g intravenous TXA 30 min before surgery and 1.0 g at intervals of 3, 6, and 9 h before surgery. The 1-dose TXA group (25 patients) received 1.0 g intravenous TXA 30 min before surgery, while the control group (32 patients) did not receive TXA. LMWH was applied 12 h after surgery in each group. The primary metrics evaluated included hidden blood loss (HBL), total blood loss (TBL), and the number and incidence rate of deep vein thrombosis (DVT). RESULTS Analysis of the HBL revealed that the 4-dose TXA group had the lowest average (583.13±318.08 ml), followed by the 1-dose TXA group (902.94±509.99 ml), and the control group showed the highest (1154.39±452.06 ml) (P<0.05). A similar result was observed for TBL (4-dose group: 640.86±337.22 ml, 1-dose group: 971.74±511.14 ml, control group: 1226.27±458.22 ml, P<0.05). Regarding DVT, the 4-dose TXA group had 5 cases (incidence rate 22.73%), the 1-dose TXA group had 6 cases (incidence rate 24.00%), and the control group had 8 cases (incidence rate 25.00%), with no significant difference among groups (P>0.05). CONCLUSIONS Treatment using 4-dose TXA and LMWH can effectively reduce PBL without increasing the DVT risk in IF patients with IMN.
Topics: Humans; Tranexamic Acid; Female; Male; Hip Fractures; Heparin, Low-Molecular-Weight; Aged; Blood Loss, Surgical; Venous Thrombosis; Prospective Studies; Middle Aged; Perioperative Care; Antifibrinolytic Agents; Aged, 80 and over; Fracture Fixation, Intramedullary
PubMed: 38875178
DOI: 10.12659/MSM.944063 -
Current Microbiology Jun 2024Two endophytic actinobacteria, strains MK5 and MK7, were isolated from the surface-sterilized root of Jasmine rice (Oryza sativa KDML 105). These strains were aerobic...
Two endophytic actinobacteria, strains MK5 and MK7, were isolated from the surface-sterilized root of Jasmine rice (Oryza sativa KDML 105). These strains were aerobic actinobacteria with a well-developed substrate and aerial mycelia that formed spiral spore chains. The type strains that shared the high 16S rRNA gene sequence similarity with both strains were Streptomyces naganishii NBRC 12892 (99.4%), "Streptomyces griseicoloratus" TRM S81-3 (99.2%), and Streptomyces spiralis NBRC 14215 (98.9%). Strains MK5 and MK7 are the same species sharing a digital DNA-DNA hybridization (dDDH) value of 95.3% and a 16S rRNA gene sequence similarity of 100%. Chemotaxonomic data confirmed the affiliation of strains MK5 and MK7 to the genus Streptomyces. Strains MK5 and MK7 contained MK-9(H) as a major menaquinone; the whole-cell sugar of both strains was galactose and glucose. The strain MK5 shared 93.4% average nucleotide identity (ANI)-Blast, 95.5% ANI-MUMmer, 93% average amino acid identity, and 61.3% dDDH with S. spiralis NBRC 14215. The polyphasic approach confirmed that strain MK5 represents a novel species, and the name Streptomyces mahasarakhamensis sp. nov. is proposed. The type strain is MK5 (= TBRC 17754 = NRRL B-65683). Genome mining, using an in silico approach and searching biosynthesis gene clusters of strains MK5 and MK7, revealed that the genomes contained genes encoding proteins relating to plant growth promotion, bioactive compounds, and beneficial enzymes. Strains MK5 and MK7 could produce indole acetic acid and solubilize phosphate in vitro.
Topics: Oryza; Streptomyces; Phylogeny; RNA, Ribosomal, 16S; Endophytes; DNA, Bacterial; Plant Roots; Plant Growth Regulators; Vitamin K 2; Bacterial Typing Techniques; Sequence Analysis, DNA; Nucleic Acid Hybridization; Fatty Acids; Base Composition
PubMed: 38874598
DOI: 10.1007/s00284-024-03747-0 -
Methods in Molecular Biology (Clifton,... 2024Photorespiration, an essential metabolic component, is a classic example of interactions between the intracellular compartments of a plant cell: the chloroplast,...
Photorespiration, an essential metabolic component, is a classic example of interactions between the intracellular compartments of a plant cell: the chloroplast, peroxisome, mitochondria, and cytoplasm. The photorespiratory pathway is often modulated by abiotic stress and is considered an adaptive response. Monitoring the patterns of key enzymes located in different subcellular components would be an ideal approach to assessing the modulation of the photorespiratory metabolism under abiotic stress. This chapter describes the procedures for assaying several individual enzyme activities of key photorespiratory enzymes and evaluating their response to oxidative/photooxidative stress. It is essential to ascertain the presence of stress in the experimental material. Therefore, procedures for typical abiotic stress induction in leaves by highlighting without or with menadione (an oxidant that targets mitochondria) are also included.
Topics: Plant Leaves; Stress, Physiological; Photosynthesis; Chloroplasts; Oxidative Stress; Enzyme Assays; Cell Respiration; Vitamin K 3; Arabidopsis; Light
PubMed: 38869793
DOI: 10.1007/978-1-0716-3973-3_10 -
International Journal of Systematic and... Jun 2024A Gram-stain-positive, aerobic bacterium, designated as YPD9-1, was isolated from the gut contents of a spotty belly greenling, , collected near Dokdo island, South...
A Gram-stain-positive, aerobic bacterium, designated as YPD9-1, was isolated from the gut contents of a spotty belly greenling, , collected near Dokdo island, South Korea. The rod-shaped cells were oxidase-positive, and catalase-negative. The major cellular fatty acids were anteiso-C, iso-C, C, iso-C and iso-C. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and two unidentified lipids. The DNA G+C content was 47.6 mol% and the predominant respiratory quinone was menaquinone MK-7. The 16S rRNA gene sequence of YPD9-1 showed low sequence similarities to species of the genus , Gsoil 1138 (97.21 % of sequence similarity), CJ25 (97.12 %) and JJ-42 (96.89 %). The results of phylogenetic analysis based on 16S rRNA gene sequences indicated that YPD9-1 formed a distinct branch among other species of the genus . The digital DNA-DNA hybridisation, average nucleotide identity, and average amino acid identity values between YPD9-1 and the related species were in the ranges of 15.3-16.2 %, 74.1-78.4 %, and 71.1-71.9 %, respectively, which are below the species cutoff values. On the basis of the results of the polyphasic analysis, we conclude that strain YPD9-1 represents a novel species of the genus , for which the name sp. nov. is proposed. The type strain of is YPD9-1 (=KCTC 43424 =LMG 32988).
Topics: RNA, Ribosomal, 16S; Base Composition; Phylogeny; DNA, Bacterial; Republic of Korea; Fatty Acids; Paenibacillus; Bacterial Typing Techniques; Sequence Analysis, DNA; Vitamin K 2; Animals; Nucleic Acid Hybridization; Phospholipids
PubMed: 38869487
DOI: 10.1099/ijsem.0.006419 -
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