Reliability of the Dilute Russel Viper Venom Time (dRVVT) in Determining Lupus Anticoagulant (LAC) in Anticoagulated Patients

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S11-S12
Author(s):  
Waleed Khan ◽  
Henry Rinder ◽  
Christopher Tormey ◽  
Alexa Siddon
Keyword(s):  
Coagulation Cascade ◽  
Factor X ◽  
Discrepant Result ◽  
Factor Ii ◽  
Anticoagulated Patient ◽  
Discrepancy Rate ◽  
The Difference ◽  
The Impact ◽  
Anticoagulated Patients ◽  
Positive Results

Abstract Objectives Antiphospholipid syndrome (APS) can be complicated by thrombosis in the presence of laboratory evidence of persistent antiphospholipid antibodies, usually in the form of a LAC. The diagnostic criteria for APS/LAC require persistent prolongation of two phospholipid-dependent clotting assays, most often the dRVVT and a thromboplastin-based phospholipid-neutralization (PN) assay. When there is discrepancy between tests, LAC diagnosis is inconclusive. This testing is complicated by anticoagulation, which may yield false positive results. We investigated the impact of various anticoagulants on LAC diagnosis by evaluating the rates of dRVVT and PN discrepancy between anticoagulated and non-anticoagulated patients. Methods dRVVT and PN (LAC panel) values were examined for 1452 consecutive patients samples since April 2017, along with anticoagulant status at the time of testing. Each LAC panel was classified as positive (both dRVVT and PN abnormal), negative (both dRVVT and PN normal), or discrepant (one normal and one abnormal). The proportion of discrepant results between anticoagulated and non-anticoagulated patients was calculated and also stratified according to the class of anticoagulant. Results Discrepant results occurred in 161 of 493 anticoagulated patient samples (33%) versus 135 of 1012 non-anticoagulated patient samples (13%). The odds ratio (OR) for a discrepant result for anticoagulated patient samples was 3.15 (95% CI=2.43–4.09) compared to non-anticoagulated patient samples. When narrowed to individual anticoagulant classes, Lovenox had the lowest chance of yielding discrepant results (OR = 1.16 95% CI= 0.51–2.66), whereas Rivaroxaban (OR = 6.9 95% CI= 4.49–10.55) and Warfarin (OR = 5.4 95% CI= 3.43–8.55) had the highest odds of yielding discrepant results. Conclusions Patient anticoagulant status is an important determinant in laboratory testing for APS/LAC. The dRVVT and PN test are 3-fold more likely to yield inconclusive results when a patient is anticoagulated; the type of anticoagulant is even more critical given the large difference in rates of discrepant results for patients on Rivaroxaban and Warfarin versus patients on Lovenox. The difference in discrepancy rate is likely due to the differential impact of each class of anticoagulant on the various components of the coagulation cascade. Rivaroxaban is a direct factor X inhibitor, and Warfarin directly lowers active factor X, amongst other, levels; by contrast, Lovenox, which was not significantly discrepant, requires antithrombin to amplify inhibition of factor II and X activity.

Dynamic Scintigraphy of the Oesophagus in the Evaluation of Reflux Oesophagitis

1990 ◽  
Vol 29 (05) ◽  
pp. 204-209
Author(s):  
B. Ugarković ◽  
D. Ivančević ◽  
D. Babić ◽  
Ž. Babić
Keyword(s):  
Reflux Oesophagitis ◽  
Oesophageal Reflux ◽  
Low Grade ◽  
Time Activity ◽  
The Difference ◽  
Asymptomatic Subjects ◽  
Oesophageal Transit ◽  
Dynamic Scintigraphy ◽  
Positive Results ◽  
Reflux Œsophagitis

A method is presented which combines gastro-oesophageal reflux quantification and oesophageal transit measurement so as to differentiate true reflux from residual oesophageal activity. A group of 33 subjects with gastro-oesophageal reflux symptoms and endoscopically confirmed reflux oesophagitis and a group of 21 asymptomatic subjects with normal oesophageal, gastric and duodenal endoscopic findings were examined. The subjects were given 37 MBq 99mTc-Sn-colloid in saline orally and then scintiscanned dynamically. The gastro-oesophageal quantification was done after transit measurement and after the oesophageal time activity (to detect residual oesophageal activity) reached its minimum. The difference in the reflux indices between the two groups was highly significant. In low-grade oesophagitis measured reflux was lower than in higher grades of disease. Only 4.7% false-positive results were observed with a specificity of 95%, indicating that this method may be superior to methods published earlier.

The Influence of Insulin, ß-Estradiol, Dexamethasone and Thyroid Hormone on the Secretion of Coagulant and Anticoagulant Proteins by HepG2 Cells

1995 ◽  
Vol 74 (02) ◽  
pp. 686-692 ◽  
Author(s):  
René W L M Niessen ◽  
Birgit A Pfaffendorf ◽  
Augueste Sturk ◽  
Roy J Lamping ◽  
Marianne C L Schaap ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Protein C ◽  
Protein Production ◽  
Culture Medium ◽  
Protein S ◽  
Cell Protein ◽  
Hepatoma Cell Line ◽  
Factor X ◽  
Factor Ii ◽  
At Iii

SummaryAs a basis for regulatory studies on the influence of hormones on (anti)coagulant protein production by hepatocytes, we examined the amounts of the plasma proteins antithrombin III (AT III), protein C, protein S, factor II, factor X, fibrinogen, and prealbumin produced by the hepatoma cell line HepG2, into the culture medium, in the absence and presence of insulin, β-estradiol, dexamethasone and thyroid hormone. Without hormones these cells produced large amounts of fibrinogen (2,452 ± 501 ng/mg cell protein), AT III (447 ± 16 ng/mg cell protein) and factor II (464 ± 31 ng/mg cell protein) and only small amounts of protein C (50 ± 7 ng/mg cell protein) and factor X (55 ± 5 ng/mg cell protein). Thyroid hormone had a slight but significant effect on the enrichment in the culture medium of the anticoagulant protein AT III (1.34-fold) but not on protein C (0.96-fold) and protein S (0.91-fold). This hormone also significantly increased the amounts of the coagulant proteins factor II (1.28-fold), factor X (1.45-fold) and fibrinogen (2.17-fold). Insulin had an overall stimulating effect on the amounts of all the proteins that were investigated. Neither dexamethasone nor ß-estradiol administration did substantially change the amounts of these proteins.We conclude that the HepG2 cell is a useful tool to study the hormonal regulation of the production of (anti)coagulant proteins. We studied the overall process of protein production, i.e., the amounts of proteins produced into the culture medium. Detailed studies have to be performed to establish the specific hormonal effects on the underlying processes, e.g., transcription, translation, cellular processing and transport, and secretion.

Evaluation of the impact of public investment programs on social and economic performance of territories

2019 ◽  
pp. 109-123
Author(s):  
I. E. Limonov ◽  
M. V. Nesena
Keyword(s):  
Bayesian Modeling ◽  
Positive Impact ◽  
Public Investment ◽  
Difference In Differences ◽  
The Public ◽  
Export Activity ◽  
Regional Investment ◽  
The Difference ◽  
The Impact ◽  
Development Institution

The purpose of this study is to evaluate the impact of public investment programs on the socio-economic development of territories. As a case, the federal target programs for the development of regions and investment programs of the financial development institution — Vnesheconombank, designed to solve the problems of regional development are considered. The impact of the public interventions were evaluated by the “difference in differences” method using Bayesian modeling. The results of the evaluation suggest the positive impact of federal target programs on the total factor productivity of regions and on innovation; and that regional investment programs of Vnesheconombank are improving the export activity. All of the investments considered are likely to have contributed to the reduction of unemployment, but their implementation has been accompanied by an increase in social inequality.

The Effect of Internal Corporate Social Responsibility on Job Satisfaction: An Empirical Study on Jordanian Pharmaceutical Companies

2020 ◽  
Vol 8 (2) ◽  
pp. 112
Author(s):  
Sura Altheeb ◽  
Kholoud Sudqi Al-Louzi
Keyword(s):  
Job Satisfaction ◽  
Corporate Social Responsibility ◽  
Social Responsibility ◽  
Quantitative Research ◽  
Skills Development ◽  
Future Research ◽  
Pharmaceutical Companies ◽  
Corporate Social ◽  
The Impact ◽  
Positive Results

The current research investigates the impact of internal corporate social responsibility on job satisfaction in Jordanian pharmaceutical companies. Quantitative research design and regression analysis were applied on a total of 302 valid returns that were obtained in a questionnaire based survey from 14 pharmaceutical companies among employees, supervisors and managers. The results showed that internal corporate social responsibility was significantly related to job satisfaction and three of its dimensions, namely working conditions, work life balance and empowerment contributed significantly to job satisfaction, whereas employment stability and skills development had no contribution. This study implies that Jordanian pharmaceutical companies have to try their best to promote and facilitate internal corporate social responsibility among their employees in an effort to improve their job satisfaction, which will eventually yield positive results for the company as a whole. In light of these results, the research presented many recommendations for future research; the most important ones were the application of this study in other sectors, cultures, and countries, and using of multi method for collecting data.

The Use of Multimedia and its Impact on Bangladeshi EFL Learners at Tertiary Level

2020 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Farzana Sharmin Pamela Islam
Keyword(s):  
Language Learning ◽  
Academic Writing ◽  
Teaching And Learning ◽  
English Language ◽  
Capital City ◽  
Tertiary Level ◽  
Language Classroom ◽  
The Difference ◽  
The Government ◽  
The Impact

As 21st century is the era of modern technologies with different aspects, it offers us to make the best use of them. After tape recorder and overhead projector (OHP), multimedia has become an important part of language classroom facilities for its unique and effective application in delivering and learning lesson. Although in many parts of Bangladesh, a South Asian developing country, where English enjoys the status of a foreign language, the use of multimedia in teaching and learning is viewed as a matter of luxury. However, nowadays the usefulness and the necessity of it are well recognized by the academics as well as the government. The study aims to focus on the difference between a traditional classroom void of multimedia and multimedia equipped classrooms at university level by explaining how multimedia support the students with enhanced opportunity to interact with diverse texts that give them more in-depth comprehension of the subject. It also focuses on audio-visual advantage of multimedia on the students’ English language learning. The study has followed a qualitative method to get an in-depth understanding of the impact of using multimedia in an English language classroom at tertiary level. For this purpose, the data have been collected from two different sources. Firstly, from students’ written response to  an open ended question as to their comparative experience of learning  lessons with and without multimedia facilities; and secondly, through  observation of English language classes at a private university of Dhaka, the capital city of Bangladesh. The discussion of the study is limited to  the use of multimedia in English language classroom using cartoons, images and music with a view to enhance students’ skills in academic writing, critical analysis of image and critical appreciation of music. For this purpose, cartoons in English language, images from Google and music from You Tube have got focused discussion in this paper.

Case study: Prediction and field tests of railway noise and effects of a low-height noise barrier

2020 ◽  
Vol 68 (4) ◽  
pp. 303-314
Author(s):  
Yuna Park ◽  
Hyo-In Koh ◽  
University of Science and Technology, Transpo ◽  
University of Science and Technology, Transpo ◽  
University of Science and Technology, Transpo ◽  
...  
Keyword(s):  
High Speed ◽  
Field Tests ◽  
Residential Areas ◽  
Railway Systems ◽  
Railway Noise ◽  
Sound Levels ◽  
Noise Barrier ◽  
The Difference ◽  
Reduction Effect ◽  
The Impact

Railway noise is calculated to predict the impact of new or reconstructed railway tracks on nearby residential areas. The results are used to prepare adequate counter- measures, and the calculation results are directly related to the cost of the action plans. The calculated values were used to produce noise maps for each area of inter- est. The Schall 03 2012 is one of the most frequently used methods for the production of noise maps. The latest version was released in 2012 and uses various input para- meters associated with the latest rail vehicles and track systems in Germany. This version has not been sufficiently used in South Korea, and there is a lack of standard guidelines and a precise manual for Korean railway systems. Thus, it is not clear what input parameters will match specific local cases. This study investigates the modeling procedure for Korean railway systems and the differences between calcu- lated railway sound levels and measured values obtained using the Schall 03 2012 model. Depending on the location of sound receivers, the difference between the cal- culated and measured values was within approximately 4 dB for various train types. In the case of high-speed trains, the value was approximately 7 dB. A noise-reducing measure was also modeled. The noise reduction effect of a low-height noise barrier system was predicted and evaluated for operating railway sites within the frame- work of a national research project in Korea. The comparison of calculated and measured values showed differences within 2.5 dB.

scholarly journals Soil Moisture Dynamics in Response to Precipitation and Thinning in a Semi-Dry Forest in Northern Mexico

Water ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 105
Author(s):  
Argelia E. Rascón-Ramos ◽  
Martín Martínez-Salvador ◽  
Gabriel Sosa-Pérez ◽  
Federico Villarreal-Guerrero ◽  
Alfredo Pinedo-Alvarez ◽  
...  
Keyword(s):  
Soil Moisture ◽  
Forest Management ◽  
Water Availability ◽  
Dry Forest ◽  
Rainfall Events ◽  
Rainfall Characteristics ◽  
Northern Mexico ◽  
The Difference ◽  
The Impact ◽  
Moisture Dynamics

Understanding soil moisture behavior in semi-dry forests is essential for evaluating the impact of forest management on water availability. The objective of the study was to analyze soil moisture based in storm observations in three micro-catchments (0.19, 0.20, and 0.27 ha) with similar tree densities, and subject to different thinning intensities in a semi-dry forest in Chihuahua, Mexico. Vegetation, soil characteristics, precipitation, and volumetric water content were measured before thinning (2018), and after 0%, 40%, and 80% thinning for each micro-catchment (2019). Soil moisture was low and relatively similar among the three micro-catchments in 2018 (mean = 8.5%), and only large rainfall events (>30 mm) increased soil moisture significantly (29–52%). After thinning, soil moisture was higher and significantly different among the micro-catchments only during small rainfall events (<10 mm), while a difference was not noted during large events. The difference before–after during small rainfall events was not significant for the control (0% thinning); whereas 40% and 80% thinning increased soil moisture significantly by 40% and 53%, respectively. Knowledge of the response of soil moisture as a result of thinning and rainfall characteristics has important implications, especially for evaluating the impact of forest management on water availability.

scholarly journals 216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S110-S110
Author(s):  
Christina Maguire ◽  
Dusten T Rose ◽  
Theresa Jaso
Keyword(s):  
Urinary Tract ◽  
Antimicrobial Therapy ◽  
Source Control ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Before And After ◽  
The Difference ◽  
Tract Infections ◽  
Length Of Therapy ◽  
The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

Arterial Stiffness Assessed by Cardio-Ankle Vascular Index in Patients With Abdominal Aortic Aneurysm and Its Alterations After Treatment

2021 ◽  
pp. 153857442110232
Author(s):  
Spyridon N. Mylonas ◽  
Konstantinos G. Moulakakis ◽  
Nikolaos Kadoglou ◽  
Constantinos Antonopoulos ◽  
Thomas E. Kotsis ◽  
...  
Keyword(s):  
Arterial Stiffness ◽  
Surgical Repair ◽  
Open Repair ◽  
Abdominal Aortic ◽  
Gender And Age ◽  
Baseline Values ◽  
The Difference ◽  
The Impact ◽  
Repair Group

Purpose: The aim of the present study was to investigate a potential difference on the arterial stiffness among aneurysm patients and non-aneurysm controls, as well as to explore potential changes between patients treated either with endovascular or open repair. Materials and Methods: A 110 patients with an infrarenal AAA were prospectively enrolled in this study. Fifty-six patients received an EVAR, whereas 54 patients received an open surgical repair. Moreover, 103 gender and age-matched subjects without AAA served as controls. The cardio-ankle vascular index (CAVI) was applied for measurement of the arterial stiffness. Results: CAVI values were statistically higher in the AAA patients when compared with control subjects. Although at 48 hours postoperatively the CAVI values were increased in both groups when compared to baseline values, the difference in CAVI had a tendency to be higher in the open group compared to the endovascular group. At 6 months of follow up the CAVI values returned to the baseline for the patients of the open repair group. However, in the endovascular group CAVI values remained higher when compared with the baseline values. Conclusion: Patients with AAAs demonstrated a higher value of CAVI compared to healthy controls. A significant increase of arterial stiffness in both groups during the immediate postoperative period was documented. The increase in arterial stiffness remained significant at 6 months in EVAR patients. Further studies are needed to elucidate the impact of a decreased aortic compliance after stentgraft implantation on the cardiac function of patients with AAA.

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