Plasma Fibrinopeptide A and Beta-Thromboglobulin in Major Bacterial Infections

SummaryThe purpose of this study was to assess the usefulness of plasma fibrinopeptide A and beta-thromboglobulin concentrations for the diagnosis of acute venous thromboembolism in patients with a major bacterial infection. In 80 controls the mean plasma fibrinopeptide A concentration was 0.72 ± 0.47 (ng/ml ± SD) and the mean plasma beta-thromboglobulin concentration 28.2 ± 10.1 (ng/ml ± SD).On admission the mean fibrinopeptide A concentration was significantly raised (5.42 ng/ml) in these patients and 17 of them had a raised fibrinopeptide A concentration. However, the mean beta-thromboglobulin concentration was not significantly different from that of the healthy individuals (35.4 ng/ml) and only three patients had an increased beta-thromboglobulin concentration.Our data show that patients with major bacterial infections tend to have increased fibrinopeptide A and normal beta-thromboglobulin concentrations. Consequently, the measuring of plasma fibrinopeptide A concentration is useless for the diagnosis of acute venous thromboembolism in these patients. However, the determination of plasma beta-thromboglobulin concentration can still be used for this purpose, since a normal beta-thrombo-globulin concentration excludes the presence of acute venous thrombosis.

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Zinc deficiency may play a crucial role in dialysis-associated bacterial infections

Journal of Renal Injury Prevention ◽

10.34172/jrip.2022.09 ◽

2020 ◽

Vol 11 (1) ◽

pp. e9-e9

Author(s):

Zahra Lotfi ◽

Abbas Ali Zeraati ◽

Elaheh Dashti ◽

Tina Zeraati ◽

Maryam Arghiany ◽

...

Keyword(s):

Zinc Deficiency ◽

Bacterial Infections ◽

Critical Role ◽

Serum Zinc ◽

Zinc Level ◽

Healthy Individuals ◽

Mortality And Morbidity ◽

Increased Risk ◽

The Mean

Introduction: Systemic bacterial infections are a common cause of mortality and morbidity in hemodialysis patients. Zinc has a critical role in several immune system functions. Patients who have enough amounts of zinc are able to better face infections caused by various pathogens in comparison to those with zinc insufficiency Objective We sought to assess the role of zinc deficiency in dialysis-associated bacterial infections. Patients and Methods: Eighty-Three adult patients with end-stage renal disease (ESRD) on hemodialysis including 43 patients with bacterial infectious complications and 40 non-infected patients as well as 41 healthy individuals were enrolled. Clinical data, laboratory values including serum zinc level and imaging findings were collected. SPSS was utilized to analyze the data with a significance cutoff set at P < 0.05. Results: Out of 124 participants, 80 (64.51%) were males and 44 (35.49%) were females. The mean age of infected hemodialysis group, non-infected hemodialysis group, and healthy controls were 50.8 ± 16.25, 49.1 ± 18.1, and 56.3 ± 18.2 years, respectively. Catheter site infection (37.3%) and urinary tract infection (30.2%) were the most common infections. The mean serum zinc concentration was significantly lower in the infected patients, compared to non-infected patients and healthy individuals (P < 0.001). Conclusion: The ESRD patients on hemodialysis have lower serum zinc levels which are associated with increased risk of bacterial infection. The role of screening for zinc deficiency and use of supplemental zinc in these patients need to be studied.

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Assay of Procarboxypeptidase U, a Novel Determinant of the Fibrinolytic Cascade, in Human Plasma

Clinical Chemistry ◽

10.1093/clinchem/45.6.807 ◽

1999 ◽

Vol 45 (6) ◽

pp. 807-813 ◽

Cited By ~ 52

Author(s):

Katinka A Schatteman ◽

Filip J Goossens ◽

Simon S Scharpé ◽

Hugo M Neels ◽

Dirk F Hendriks

Keyword(s):

Human Plasma ◽

Binding Sites ◽

Hippuric Acid ◽

Active Form ◽

Reference Interval ◽

Healthy Individuals ◽

High Affinity ◽

Lysine Residues ◽

The Mean

Abstract Background: Procarboxypeptidase U (proCPU) is a novel proenzyme found in human plasma. The active form, carboxypeptidase U (CPU; EC 3.4.17.20), retards the rate of fibrinolysis through its ability to cleave C-terminal lysine residues on fibrin partially degraded by plasmin. This reduces the number of high-affinity plasminogen-binding sites on fibrin. Methods: We developed an assay to determine the proCPU concentration in human plasma. The assay involved quantitative conversion of proCPU to active CPU by thrombin-thrombomodulin, a very efficient activator of proCPU, followed by determination of the enzymatic activity of CPU with the substrate hippuryl-l-arginine, using an HPLC-assisted determination of the released hippuric acid. Using this method, we established a reference interval based on 490 healthy individuals. Results: The mean proCPU concentration, determined after activation of the zymogen in diluted plasma and expressed as CPU activity, was 964 U/L, with a SD of 155 U/L. The population showed a gaussian distribution. However, we noticed important differences related to age and the use of hormone preparations. Conclusions: The sensitivity and precision of the method make it suitable for routine clinical determinations and as a reference procedure.

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Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

TH Open ◽

10.1055/s-0040-1714210 ◽

2020 ◽

Vol 04 (03) ◽

pp. e178-e188

Author(s):

Maria Farm ◽

Aleksandra Antovic ◽

David E. Schmidt ◽

Niklas Bark ◽

Nida Soutari ◽

...

Keyword(s):

Venous Thromboembolism ◽

Venous Thrombosis ◽

Thrombin Generation ◽

Medical Emergency ◽

Diagnostic Study ◽

Healthy Controls ◽

Clinical Biomarkers ◽

Acute Venous Thromboembolism ◽

Fibrin Monomers ◽

D Dimer

Abstract Introduction For acute venous thromboembolism (VTE), a biomarker with higher specificity than D-dimer would be of great clinical use. Thrombin generation and overall hemostatic potential (OHP) reflect the hemostatic balance by globally assessing multiple coagulation factors and inhibitors. These tests discriminate between healthy controls and patients with a prothrombotic tendency but have yet to be established as clinical biomarkers of VTE. Objective This study compares endogenous thrombin potential (ETP) and OHP to D-dimer and fibrin monomers (FM) in outpatients with suspected VTE. Methods A cross-sectional diagnostic study where 954 patients with suspected pulmonary embolism or deep venous thrombosis were recruited consecutively from the medical emergency department at Karolinska University Hospital. D-dimer, FM, OHP, and ETP were analyzed in a subpopulation of 60 patients with VTE and 98 matched controls without VTE. VTE was verified either by ultrasonography or computed tomography and clinical data were collected from medical records. Results Compared with healthy controls, both VTE and non-VTE patients displayed prothrombotic profiles in OHP and ETP. D-dimer, FM, ETP area under the curve (AUC), and ETP Tlag were significantly different between patients with VTE and non-VTE. The largest receiver-operating characteristic AUCs for discrimination between VTE and non-VTE, were found in D-dimer with 0.94, FM 0.77, and ETP AUC 0.65. No useful cutoff could be identified for the ETP or the OHP assay. Conclusion Compared with D-dimer, neither ETP nor OHP were clinically viable biomarkers of acute venous thrombosis. The data indicated that a large portion of the emergency patients with suspected VTE were in a prothrombotic state.

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The Interaction of Sickle Cell Trait and Anticardiolipin Antibodies in Venousthromboembolism

Blood ◽

10.1182/blood-2021-151564 ◽

2021 ◽

Vol 138 (Supplement 1) ◽

pp. 4261-4261

Author(s):

Chinedu A Ezekekwu ◽

Taiwo R Kotila ◽

Chinonso Chiemeka Anyanwu-Yeiya ◽

Titilola S. Akingbola ◽

Bamidele Tayo

Keyword(s):

Risk Factors ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Venous Thrombosis ◽

Sickle Cell ◽

Antiphospholipid Antibodies ◽

Sedentary Lifestyle ◽

Sickle Cell Trait ◽

Anticardiolipin Antibodies ◽

The Mean

Abstract Introduction Among the risk factors for venous thromboembolism (VTE) are inheritance of the sickle cell gene and antiphospholipid syndrome. Antiphospholipid antibodies are elevated in sickle cell disease but there is little information on its levels in sickle cell trait. The prevalence of anticardiolipin antibodies and association with VTE is equally not known in the Nigerian population. Methods A case control study involving 50 consecutive patients with Doppler confirmed venous thromboembolism at the University College Hospital Ibadan and 50 apparently healthy individuals. Haemoglobin electrophoresis was carried out using cellulose acetate membrane. IgG and IgM anticardiolipin antibodies were assayed by ELISA. Results The mean age of the patients was 58.7±18.5years, range of 21-89 years, there were 21 males (42%). Majority of the patients (42 (84%)) had deep venous thrombosis while five (10%) patients presented with pulmonary embolism, one had both deep venous thrombosis and pulmonary embolism. A patient had portal vein thrombosis and another, an intracardiac clot. Sedentary lifestyles, hypertension and concomitant malignancy were the most prevalent risk factors (34% each) (figure I). Both sedentary lifestyle and cancer were significantly associated with VTE (p<0.001). Sickle cell trait (Hb AS) occurred in the same number of patients and controls (eleven each). Higher levels of both IgG and IgM anticardiolipin antibodies were found among the VTE patients with sickle cell trait than controls. (Table 1) The mean levels of IgG antibody in Hb AS patients was 31.7 ± 12.8 GPL compared to 25 ± 13.8 GPL in the controls (p= 0.254) and mean IgM anticardiolipin antibodies in Hb AS patients was 18.7 ± 6.2 GPL while that of the controls was 16.8 ± 11.6 GPL (p= 0.633). The global mean levels of IgG and IgM anticardiolipin antibodies in the patients with VTE were 29.7 ± 9.1 GPL and 24.8 ±16.7 GPL respectively versus 28.5 ±13.7 GPL and 25.2 ±16.2 GPL in the controls. A multivariable logistic regression showed age, sedentary lifestyle and anemia as independent risk factors while a positive IgM anticardiolipin antibody appeared protective for VTE. (Table 2) Conclusion The prevalence of sickle cell trait and anticardiolipin levels did not differ between VTE patients and healthy controls. Age, hypertension, sedentary lifestyle and malignancies were identified risk factors in our cohort of patients. Larger prospective studies may be helpful in determining the influence of sickle cell trait and antiphospholipid antibodies in venous thromboembolism. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

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Cycloplegic Effects on the Cylindrical Components of the Refraction

Journal of Ophthalmology ◽

10.1155/2021/8810782 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Athar Zareei ◽

Milad Abdolahian ◽

Shahram Bamdad

Keyword(s):

Precise Determination ◽

Lower Amount ◽

Healthy Individuals ◽

Male And Female ◽

Near Vision ◽

Before And After ◽

The Mean ◽

The Right ◽

Age Range

It is important to predict which astigmatic patients require separate refraction for near vision. This study compared cylindrical components changes by cyclopentolate 1% for the low and high amount of astigmatism. The right eyes of 1014 healthy individuals (307 males and 707 females) with cylindrical refractive power more than −0.5 diopter on autorefractometer were selected. Both male and female patients in the age range of 17–45 years were refracted before and after cycloplegia, using 1% cyclopentolate. All volunteers were classified into 2 subgroups including the lower astigmatism group (−2.25 to −0.50) and the higher astigmatic group (−2.50 to over). Alpines’ method was used to compare the effect of cycloplegic drop on cylindrical power. The mean age in the lower astigmatism group (29.58; 95% CI: 29.18 to 29.99 years) was not significantly different from the higher astigmatic group (29.85; 95% CI: 29.07 to 30.62) and there were no significant differences in gender between these two groups ( P = 0.54 ). Differences between wet and dry refraction in J0 (−0.03; 95% CI:−0.06 to −0.008) and J45 (−0.03; 95% CI:−0.06 to −0.01) were significant only in the higher astigmatic group. Axis changes by the cycloplegic drop in the lower astigmatism group were 3.51 (CI: 3.22 to 3.81) and axis changes by the cycloplegic drop in the higher astigmatism group were 2.21 (CI: 1.73 to 2.49). In patients with a lower amount of astigmatism (−2.25 to −0.50), additional near subjective refraction could be done for precise determination of axis and in patients with a higher amount of astigmatism (−2.50 to over), near subjective refraction might be done for precise determination of power.

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A New Radioimmunoassay-Technique For Fibrinopeptide-A In Human Plasma

10.1055/s-0038-1665772 ◽

1979 ◽

Author(s):

J Harenberg ◽

R Zimmermann ◽

F Haas ◽

H Schmidt-Gayk

Keyword(s):

Myocardial Infarction ◽

Venous Thrombosis ◽

Human Plasma ◽

Original Method ◽

Fibrinopeptide A ◽

Microtiter Plates ◽

Antibody Method ◽

The Mean ◽

Mean Concentration ◽

Healthy Persons

Fibrinopeptide-A (FpA) is thought to be the most sensitive parameter to indicate hypercoagulability with increased fibrin formation in man. Previously described radioimmunoassays for FpA are very time consuming. We present therefore a modification of the assay, which is less time consuming, sensitive, reproducable and reliable. The following modifications were made on the original method: 1. plasma dialysis was omitted 2. performance on microtiter-plates 3. double antibody method.The sensitivity was improved to 0.16 ng FpA / ml plasma. The mean concentration of FpA in dialysed and undialysed plasma did not differ significantly (p<0.001). Effective separation of fibrinogen was achieved by aethanol extraction alone. The mean concentration of FpA correlated highly, when the tracer was separated by charcoal or second antibody (r = 0.96). The recovery was improved to 85%.In healthy persons 0.16-2.5 ng FpA/ml plasma were measured. In patients with venous thrombosis or myocardial infarction in the history FpA was elevated significantly to 2.0 ng/ml-19.6 ng/ml, indicating that the FpA is a usefull tool in diagnosis of hypercoagulability.

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Determination of Colistin in Contents Derived from Gastrointestinal Tract of Feeding Treated Piglet and Broiler

Antibiotics ◽

10.3390/antibiotics10040422 ◽

2021 ◽

Vol 10 (4) ◽

pp. 422

Author(s):

Chun Peng ◽

Sanling Zuo ◽

Yinsheng Qiu ◽

Shulin Fu ◽

Lijuan Peng

Keyword(s):

Bacterial Infections ◽

Ecological Environment ◽

Resistant Bacteria ◽

Quantitative Mass Spectrometry ◽

Limit Values ◽

Quantitation Limit ◽

The Mean ◽

Potential Impact ◽

The Impact

Colistin is considered as the last-resort treatment for multiantibiotic-resistant Gram-negative bacterial infections in humans. However, the oral administration of colistin to livestock and poultry results in the introduction of large amounts of colistin to the surrounding environment via urine and feces, potentially inducing the prevalence of colistin-resistant bacteria and the impact on the ecological environment. We established a quantitative mass spectrometry (MS) based method to measure colistin in contents recovered from the gastrointestinal segments of piglets and broilers, as well as colistin in feces from the animals. The mean recoveries of colistin from different matrices were between 73.2% and 103.9%. The quantitation limit values for different matrices ranged from 0.37 to 1.85 ng/g. In colistin-treated swine samples, the highest concentration of colistin was detected in feces samples at a level of 1248.3 ng/g. However, the highest concentration of colistin in broiler samples was around 4882.9 ng/g, which was found in the contents derived from broilers’ ceca. The employment of the proposed method to assess colistin in animals’ gastrointestinal tracts might help to understand the colistin absorption in animals’ guts and the potential impact of colistin on the emergence of resistant bacteria in animals’ gut flora and the ecological environment.

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Procalcitonin Serum Level in Patients Aged 3-36 Months With Focal Fever Referred to Hospitals in Western Iran in 2020

Avicenna Journal of Clinical Microbiology and Infection ◽

10.34172/ajcmi.2021.18 ◽

2021 ◽

Vol 8 (3) ◽

pp. 98-101

Author(s):

Ali Keramati ◽

Sahereh Garaei ◽

Shiva Roshankhah ◽

Mojtaba Esmaeli

Keyword(s):

Serum Level ◽

Bacterial Infection ◽

Plasma Levels ◽

Bacterial Infections ◽

Viral Infections ◽

High Sensitivity ◽

Pediatric Emergency ◽

Reactive Protein ◽

Level Measurement ◽

The Mean

Background: Diagnosing viral and bacterial infectious diseases in children is of great importance. The conventional treatment for the given diseases has been proven relatively impractical and, therefore, finding a practical diagnostic method seems necessary. Measuring procalcitonin (PCT) levels in the blood is one of those useful tests which have high sensitivity and specificity compared to other methods. Moreover, many researchers have emphasized that the level of PCT in bacterial infections is significant. Therefore, PCT level measurement can be adopted as a highly effective factor for distinguishing bacterial infections from viral ones. Our study aimed to evaluate the plasma levels of PCT in children aged 3-36 months. Methods: In this study which was conducted in 2020 in Kermanshah, Iran, 49 children aged 3-36 months having focal fever and referring to the pediatric emergency department of Mohammad Kermanshahi and Imam Reza hospitals in Kermanshah were examined. Distinguishing bacterial infection from viral one was first made by a pediatrician using CBC diff-ESR-CRP tests. Results: The mean serum level of PCT in bacterial infections was significantly higher than that in viral infections. Furthermore, the mean of white blood cell (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) in bacterial infection was significantly higher than that in viral infection. Conclusions: According to our study findings, plasma levels of PCT could have been considered as a diagnostic indicator of the infection. Therefore, it was recommended that the evaluation of PCT plasma levels in children with infection be performed in early stages of the disease. However, it was also suggested that this evaluation be conducted after performing further investigations in this field.

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Factor VIII Levels Measured at the Time of Diagnosis of Acute Idiopathic Venous Thromboembolism Are Higher Then When Measured Six-Months Post Diagnosis.

Blood ◽

10.1182/blood.v106.11.4136.4136 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4136-4136

Author(s):

Michael J. Kovacs ◽

Michael Keeney ◽

Karen MacKinnon

Keyword(s):

Venous Thromboembolism ◽

Factor Viii ◽

Oral Anticoagulation ◽

Oral Anticoagulants ◽

Acute Phase Reactant ◽

First Episode ◽

Optimal Timing ◽

Reference Curve ◽

The Mean ◽

Acute Venous Thromboembolism

Abstract Background: Thrombophilia screens are performed frequently in persons with a history of acute venous thromboembolism especially in those for whom the etiology is unprovoked or idiopathic. The optimal timing of the thrombophilia screen is controversial. Elevation of Factor VIII levels are a more recently described thrombophilia that is felt to be hereditary, however, the exact mode of inheritance is not certain. Factor VIII is also known to be elevated as an acute phase reactant. The accuracy of assessing Factor VIII levels at the time of diagnosis of acute venous thromboembolism is not known. The purpose of this study was to determine if there is a difference in Factor VIII levels measured at the time of diagnosis of acute venous thromboembolism as compared to six months later while patients are on oral anticoagulation. Methods: Consecutive patients with a first episode of idiopathic acute venous thromboembolism were eligible. Patients were excluded if they were <18 years of age or had already been started on oral anticoagulants. Plasma was collected within 48 hours of diagnosis in.105 mmol sodium citrate, double spun at 1,500 G and frozen at −70 Celsius for batch testing. Factor VIII levels were assessed with a three point assay on an ACL 9000 (Beckman Coulter, Mississauga). A seven-point reference curve was used for all factor assays. Linear regression showed r2 values were always > 0.99 on calibration lines. Controls at two levels, 1.00 U/mL normal pooled plasma and 0.32 U/mL were run with all assays. All patients were treated with dalteparin at 200u/kg sc daily for 5–7 days and simultaneously initiated on warfarin for six months. At the six-month point repeat Factor VIII assessments were performed while the patients were still receiving oral anticoagulation with warfarin. Results: There were 61 patients (37 male) and the mean age was 50.4 years (18–85 years). Thirty patients had deep vein thrombosis, 23 pulmonary embolism and 8 patients had both diagnoses. The patients’ Factor VIII levels at baseline and six months were compared. At baseline the mean Factor VIII level was 1.77 units/ml and at six months it was 1.59 units/ml. The 95% confidence interval for difference in means was 0.04 – 0.32. These results were statistically significant, (paired t-test p=.01). Conclusion: This study confirms that caution should be used in interpreting Factor VIII levels drawn as part of a thrombophilia screen at the time of diagnosis of acute idiopathic venous thromboembolism. Factor VIII levels will be lower six-months later when patients are stable on oral anticoagulation.

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A New Radioimmunoassay-Technique for Fibrinopeptide-a in Human Plasma

10.1055/s-0039-1684501 ◽

1979 ◽

Author(s):

J. Harenberg ◽

H. Zimmermann ◽

F. Haas ◽

H. Schmidt-Gayk

Keyword(s):

Myocardial Infarction ◽

Venous Thrombosis ◽

Human Plasma ◽

Original Method ◽

Fibrinopeptide A ◽

Microtiter Plates ◽

Antibody Method ◽

The Mean ◽

Mean Concentration ◽

Healthy Persons

Fibrinopeptide-A (FpA) is thought to be the most sensitive parameter to indicate hypercoagulability with increased fibrin formation in man. Previously described radioimmunoassays for FpA are very time consuming. We present therefore a modification of the assay, which is less time consuming, sensitive, reproducable and reliable. The following modifications were made on the original method: 1. plasma dialysis was omitted 2. performance on microtiter-plates 3. double antibody method.The sensitivity was improved to 0.16 ng FpA/ml plasma. The mean concentration of FpA in dialysed and undialysed plasma did not differ significantly (p<0,001). Effective separation of fibrinogen was achieved by aethanol extraction alone. The mean concentration of FpA correlate, highly, when the tracer was separated by charcoal or second antibody (r = 0.96). The recovery was improved to 85%.In healthy persons 0.16-2.5 ng FpA/ml plasma were measured. In patients with venous thrombosis or myocardial infarction in the history FpA was elevated significantly to 2.0 ng/ml-19.6 ng/ml, indicating that the FpA is a usefull tool in diagnosis of hypercoagulability.

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