Disseminated intravascular coagulation (DIC) results in the catastrophic simultaneous activation of thrombotic and hemorrhagic processes. Its pathophysiology and the role of inflammation and ...microparticles (MPs) are not fully understood. Microparticles represent small phospholipid-expressing procoagulant vesicular fragments, released with cellular disruption and apoptosis. Functional MPs were measured in 100 random patients from a population of patients with DIC. Plasma samples from 30 normal male and female volunteers were used as control. Commercial Annexin trapping method was used to determine procoagulant activity of MPs. Mean ± SD concentration of MPs in the DIC group was 24.6 ± 14.2 nmol/L (range: 0.0-60.0 nmol/L), significantly higher than the control group: 8.5 ± 4.3 nmol/L (range: 1.3-17.4 nmol/L). Distribution curves and scattergrams showed that MPs concentration in the DIC samples was more widespread. This demonstrates that MPs are upregulated in patients with DIC and may mediate the hemostatic activation and inflammatory responses in this syndrome.
The primary objective of this preliminary study was to examine the impact of NFL play on interregional functional connectivity between two brain regions, the supramarginal gyrus (SMG) and the ...thalamus, identified as having higher binding of
CDPA-713 in NFL players. The authors' secondary objective was to examine the effect of years since play on the interregional connectivity.
Resting-state functional MRI was used to examine functional brain changes between regions with evidence of past injury in active or recently retired NFL players (defined as ≤12 years since NFL play) and distantly retired players (defined as >12 years since NFL play). Age-comparable individuals without a history of concussion or participation in collegiate or professional collision sports were included as a control group.
Compared with healthy control subjects, NFL players showed a loss of anticorrelation between the left SMG and bilateral thalami (mean z score=-2.434, p=0.015). No difference was observed when examining right SMG connectivity. The pattern of connectivity in active and recently retired players mimicked the pattern observed in distantly retired players and older control subjects.
Further study of the clinical significance of this altered pattern of interregional connectivity in active and recently retired NFL players is needed.
Disseminated intravascular coagulation (DIC) represents one of the most catastrophic coagulopathies, which results in the simultaneous activation of thrombotic and hemorrhagic processes. The ...pathophysiology of DIC, and the role of inflammation and Microparticles (MPs) is not fully understood. MPs represent small phospholipid‐expressing, procoagulant vesicular fragments, which are released from platelets, leukocytes, and endothelial cells due to cellular disruption and apoptosis. This study was designed to measure functional MPs in 100 random patients from a population of patients diagnosed with DIC. Plasma samples from 30 normal male and female volunteers were used as control. A commercially available functional MP method based on Annexin trapping was used for the determination of the procoagulant activity of MPs (Hyphen Biomedical, Paris, France). The Mean ± Standard Deviation concentration of MPs in the DIC group was 24.6 ± 14.2 nM (Range: 0.0 – 60.0 nM), which was significantly higher than the concentration in the Normal Human Plasma (NHP) control group: 8.5 ± 4.3 nM (Range: 1.3 – 17.4 nM). The distribution curves and the scattergram showed that the MPs concentration in the DIC samples was more widespread than in the NHPs. This study clearly demonstrates that MPs are upregulated in patients with DIC and may mediate the hemostatic activation and inflammatory responses in this syndrome.
In End Stage Renal Disease (ESRD), systemic vascular changes contribute to thrombotic comorbidities. The purpose of this study was to characterize the role of vWF in these inflammatory changes. ...Plasma samples from 51 patients with clinically confirmed (ESRD) were collected prior to maintenance hemodialysis. A group of 50 normal individuals, both male and female, was included as control. Concentrations of von Willebrand Factor (vWF) and von Willebrand Factor Propeptide (vWFpp) were quantified using the GTI® vWF & Propeptide Assay. Compared to controls, the levels of vWF and vWFpp were increased in patients with ESRD. These patients showed a 1.3 fold increase in vWF (mean 128 ± 69 U/dL, range 9.2 to 308) compared to control (mean 100 ± 60, range 22 to 332). Similarly, there was a 1.6 fold increase in vWFpp (mean 148 ± 92 U/dL, range 8.0 to 361) compared to control (mean 92 ± 23, range 60 to 163). However, the ratio of vWFpp:vWF (mean 1.2 ± 0.6, range 0.4 to 3.3) was unchanged compared to control. This study shows a previously uncharacterized increase in vWFpp and validates the up‐regulation of vWF in ESRD. The normal vWFpp:vWF ratio implies an increased production in vWF in response to endothelial damage without any apparent down‐regulation of ADAMTS‐13 mediated degredation of vWF. Further studies are required to assess the role of ADAMTS‐13 in ESRD to better understand the interplay of all these components.
Plasma samples from 39 patients with clinically confirmed end‐stage renal disease (ESRD) were collected prior to a maintenance hemodialysis. A pilot group of ten normal individuals, both male and ...female, were included as control. Cerebral Array II chips were used in the Randox® system to simultaneously measure Neuron Specific Enolase (NSE), Neutrophil Gelatinase‐associated Lipocalin (NGAL), Soluble Tumor Necrosis Factor Receptor I (TNFRI), D‐Dimer (DD), Thrombomodulin (TM), and C‐reactive protein (CRP). As compared to normals, all markers studied showed an upregulation in ESRD patients. Most notably TNFRI showed a 25 fold increase in patients with ESRD (mean 7.4 ± 2.4, range 3.1 to 13.6) compared to the control (mean 0.3 ± 0.1, range 0.2 to 0.5). TM showed a 6.6 fold increase (mean 7.0 ± 2.5, range 2.5 to 14.1) compared to control (mean 1.1 ± 0.2, range 0.8 to 1.4), and NGAL showed a 5.5 fold increase (mean 1416 ± 203, range 839 to 1729), compared to control (mean 257 ± 74, range 115 to 377). Increases in CRP and DD were also noted up to 2.8 fold. These studies show that some newer markers such as TNFRI, NGAL and NSE are upregulated in ESRD. However, the clinical significance of these markers still needs to be further explored. In addition, this study validates the role of endothelial damage and endogenous thrombotic processes in ESRD as evidenced by the increased levels of thrombomodulin and D‐Dimer.
Oral Cancer Carole Fakhry, Karen T. Pitman, Ana P. Kiess
2020
eBook
A state-of-the-art guide on oral cancer management from distinguished experts! Oral Cancer: Evaluation, Therapy, and Rehabilitation edited by prominent Johns Hopkins clinicians and educators Carole ...Fakhry, Karen Pitman, Ana Kiess, and David Eisele provides a comprehensive, state-of-the-art review on the diagnosis and management of oral cancer. This unique resource fills a void in the literature by exploring surgical and reconstructive issues specific to each subsite of the oral cavity. Important pre- and post-treatment evaluations by dental, speech language pathology, and the oncologic care team are reviewed. The comprehensive book is divided into 10 sections, each focused on different facets of the patients' trajectory. The text starts with epidemiology of oral cavity cancer and discussion of patient populations at increased risk of oral cavity cancer. The book details pre-cancers, multidisciplinary diagnostic evaluations, treatment, post-treatment, recurrent and metastatic oral cancer, and palliative care, concluding with future directions such as chemoprevention. A full spectrum of oral neoplasms are covered in depth, including different types of squamous cell cancer, primary malignancies of the mandible, and sublingual and minor salivary gland malignancies. Key Features * All oral cavity subsites are approached from both an ablative and reconstructive standpoint, with dedicated chapters focused on specific oral cancer reconstructive techniques * Discussion of oncologic considerations encompassing radiation and medical oncology including definitive radiation therapy, brachytherapy, adjuvant radiation therapy, and adjuvant chemotherapy/novel therapeutics * Clinical pearls cover complications of both surgery and radiation therapy, as well as psychological and dental implications of therapy * High-quality illustrations, photographs, and videos further elucidate impacted anatomy and techniques Residents and clinicians in otolaryngology-head and neck surgery, oral and maxillofacial surgery, head and neck reconstructive surgery, medical oncology, and radiation oncology will benefit from reading this excellent resource. Dentists who wish to further their knowledge about oral cancers will also find it an invaluable reference.
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