Association Between Soluble CD40L with Thrombosis Occurrence and JAK2 V617F Mutation in Essential Thrombocythemia
Wafaa S. Mohammed,
Wael A. Abbas,
Ola A. Afifi,
Ahmad F. Thabet
Issue:
Volume 4, Issue 4, July 2016
Pages:
60-65
Received:
2 May 2016
Accepted:
21 May 2016
Published:
4 June 2016
Abstract: Thrombo-haemorrhagic events are the main cause of mortality in essential thrombocythemia (ET). The aim of this study was to measure soluble CD40 ligand (sCD40L) in the plasma of healthy individuals and in patients with an elevated platelet count and investigate the association of sCD40L with thrombosis in ET patients and their JAK2 V617F mutation. The plasma levels of sCD40L was measured in 75 patients. 35 patients diagnosed as ET, 25 patients diagnosed as reactive thrombocytosis (RT), 15 patients with low platelet count and 15 healthy subjects acted as the control group. 35 ET patients were assessed for JAK2 V617F status by utilizing a JAK2 V617F specific quenching probe. ET patients had the highest levels of sCD40L compared to the patients with RT and controls (225.70±79.34, 160.40±54.54 and 83.54±21.54) respectively and a tight correlation was found between the platelet count and sCD40L. Statistical analysis revealed that the JAK2 V617F mutation was associated with significantly increased levels of WBCs (p˂0.04) and sCD40L (p˂0.001) compared to JAK2 V617F negative patients. There was no significant association between JAK2 V617F mutation and thrombosis, but the level of sCD40L was significantly higher in patients with thrombosis than those without thrombosis (236.43 ± 75.93 vs 184.65 ± 62.31) respectively. Based on these findings, the presence of JAK2 mutation may changes the expression of soluble markers of endothelial and platelet activation besides the quantitative and qualitative changes in platelets. Mechanisms leading to thrombosis are more complex and multifactorial.
Abstract: Thrombo-haemorrhagic events are the main cause of mortality in essential thrombocythemia (ET). The aim of this study was to measure soluble CD40 ligand (sCD40L) in the plasma of healthy individuals and in patients with an elevated platelet count and investigate the association of sCD40L with thrombosis in ET patients and their JAK2 V617F mutation. ...
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Treatment with Tyrosine Kinase Inhibitors in Chronic Myeloproliferative Neoplasms: Pros and Cons
Issue:
Volume 4, Issue 4, July 2016
Pages:
66-74
Received:
10 June 2016
Accepted:
20 June 2016
Published:
4 July 2016
Abstract: Myeloproliferative neoplasms (MPNs) are a group of hematological disorders characterized by proliferation of one or more than one myeloid lineage. Genetically they express single or multiple mutations of the Janus tyrosine kinase receptors. Advances in understanding molecular and cytogenetic pathophysiology of MPNs led to further identification of different mutations rather than the classical break point cluster region Abelson (BCR-ABL). Although the onset of disease in all MPNs is insidious and may be asymptomatic, also MPNs run a slowly progressive course however they carry the potential of blastic transformation. Furthermore, peripheral blood leucocytosis, thrombocytosis or erythroctosis can lead to a wide array of fatal complications. Originally treatment of MPNs based on cytoreduction and supportive measures. Tyrosine kinase inhibitors (TKIs) are a group of anti-neoplastic drugs that specifically targeting malignant cells. Many studies proved the efficacy and safety of TKIs in management of patients with MPNs. This study was conducted to evaluate TKIs, pros and cons.
Abstract: Myeloproliferative neoplasms (MPNs) are a group of hematological disorders characterized by proliferation of one or more than one myeloid lineage. Genetically they express single or multiple mutations of the Janus tyrosine kinase receptors. Advances in understanding molecular and cytogenetic pathophysiology of MPNs led to further identification of ...
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Mortality in a Primary and Secondary Transported of STEMI Patients, a Prospective Study
Al Mawiri A.,
Stasek J.,
Vojáček J.,
Bis J.,
Albahri Z.
Issue:
Volume 4, Issue 4, July 2016
Pages:
75-78
Received:
30 June 2016
Accepted:
19 July 2016
Published:
29 July 2016
Abstract: In ST-elevation myocardial infarction (STEMI), the pre-hospital phase is the most critical and appropriate treatment in a timely manner which is instrumental for mortality reduction. STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service (EMS) are pivotal. The first steps are devoted to minimizing patient’s delay in seeking care, quickly dispatching emergency personnel with equipped ambulance to be able to make the diagnosis on scene, deliver initial drug and therapy and also transport the patient to the most appropriate (not necessarily the closest) cardiac facility or hospital. Primary percutaneous coronary intervention (PCI) is a treatment of choice, but thrombolysis followed by coronary angiography and possibly PCI are valid alternatives. Strong cooperations between cardiologists and emergency medicine doctors are mandatory for optimal pre-hospital STEMI care. In this study, we prospectively recorded door to balloon time (DBT) for consecutive patients with STEMI, treated by PCI. For six hundred and seventy seven patients with mean 64 ± 16 years, 475 (70%) males and 202 (30%) females were enrolled for the final analysis. From this number, 354 (52.3%) patients had primary transport by emergency services (PT) and 323 (47.7%) secondary transport (ST). Median of DBT was 34 ±15.9 mins for PT patients (n=354) and 100 ±28.8 mins for patients with ST (n=323) (p<0.00005). One month mortality rate was 4% vs 9.5% (p=0.002) in the PT vs ST group, respectively. One-year mortality rate in the PT and ST groups were 7.3% vs 20.5% (p<0.005), respectively. We found out that patients who were sent directly to a PCI center had significantly shorter time for reperfusion and lower mortality.
Abstract: In ST-elevation myocardial infarction (STEMI), the pre-hospital phase is the most critical and appropriate treatment in a timely manner which is instrumental for mortality reduction. STEMI systems of care based on networks of medical institutions connected by an efficient emergency medical service (EMS) are pivotal. The first steps are devoted to m...
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