Journal Description
Journal of Clinical Medicine
Journal of Clinical Medicine
is an international, peer-reviewed, open access journal of clinical medicine, published semimonthly online by MDPI. The International Bone Research Association (IBRA), Italian Resuscitation Council (IRC), Spanish Society of Hematology and Hemotherapy (SEHH), Japan Association for Clinical Engineers (JACE), European Independent Foundation in Angiology/ Vascular Medicine (VAS) and others are all affiliated with JCM, and their members receive a discount on article processing charges.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, CAPlus / SciFinder, and other databases.
- Journal Rank: JCR - Q1 (Medicine, General and Internal) / CiteScore - Q1 (General Medicine)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 17.3 days after submission; acceptance to publication is undertaken in 2.7 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Companion journals for JCM include: Epidemiologia, Transplantology, Uro, Sinusitis, Rheumato, Journal of Clinical & Translational Ophthalmology, Journal of Vascular Diseases, Osteology, Complications, Therapeutics, and Sclerosis.
Impact Factor:
3.0 (2023);
5-Year Impact Factor:
3.4 (2023)
Latest Articles
Clinical and Physiological Variables in Patients with Post-COVID-19 Condition and Persistent Fatigue
J. Clin. Med. 2024, 13(13), 3876; https://doi.org/10.3390/jcm13133876 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: Post-COVID-19 condition can manifest through various symptoms such as dyspnea, cognitive disturbances, and fatigue, with mechanisms related to these symptoms, particularly those related to fatigue, still requiring further clarification. Therefore, our aim was to assess the clinical and physiological variables in
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Background/Objectives: Post-COVID-19 condition can manifest through various symptoms such as dyspnea, cognitive disturbances, and fatigue, with mechanisms related to these symptoms, particularly those related to fatigue, still requiring further clarification. Therefore, our aim was to assess the clinical and physiological variables in patients with post-COVID-19 condition and persistent fatigue. Methods: After one year post-COVID-19 infection, the patients underwent a comprehensive evaluation, including a complete blood count, a metabolic panel, complete spirometry, and assessments of dyspnea, quality of life, anxiety and depression, physical capacity, body composition, muscle strength, comorbidities, and medications. The participants were categorized into two groups: G1—fatigue and G2—non-fatigue. Results: Seventy-seven patients (53% female; 55 ± 11.8 years) were included, 37 in G1 and 40 in G2. As for clinical markers and symptoms of illness, in those with persistent fatigue symptoms, a greater sensation of dyspnea [BDI score: 7.5 (6–9) vs. 12 (9–12), p < 0.001; mMRC score: 1 (1–2) vs. 0 (0–1), p = 0.002], worse quality of life [SGRQ total score: 1404 (1007–1897) vs. 497 (274–985); p < 0.001], higher levels of anxiety [HADS-A score: 8 (5–9) vs. 3 (0.5–4); p < 0.001], and a reduction in peripheral and inspiratory muscle strength [handgrip strength: 34 (28–40) vs. 40 (30–46.5) kgf, p = 0.044; MIP: −81 ± 31 vs. −111 ± 33 mmHg, p < 0.001)] were observed. Conclusions: Those with persistent fatigue exhibited a greater sensation of dyspnea, higher levels of anxiety, reduced peripheral and inspiratory muscle strength, and a greater impairment of quality of life. The severity of fatigue was influenced by the worsening quality of life, heightened anxiety levels, and decreased peripheral muscle strength. Additionally, the worse quality of life was associated with a higher sensation of dyspnea, lower muscle strength, and reduced physical capacity.
Full article
(This article belongs to the Section Epidemiology & Public Health)
Open AccessSystematic Review
Vaginal Microbiome and Pregnancy Complications: A Review
by
Angeliki Gerede, Konstantinos Nikolettos, Eleftherios Vavoulidis, Chrysoula Margioula-Siarkou, Stamatios Petousis, Maria Giourga, Panagiotis Fotinopoulos, Maria Salagianni, Sofoklis Stavros, Konstantinos Dinas, Nikolaos Nikolettos and Ekaterini Domali
J. Clin. Med. 2024, 13(13), 3875; https://doi.org/10.3390/jcm13133875 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: There are indications that the microbial composition of the maternal mucosal surfaces is associated with adverse events during pregnancy. The aim of this review is to investigate the link between vaginal microbiome alterations and gestational complication risk. Methods: This comprehensive literature review
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Background/Objectives: There are indications that the microbial composition of the maternal mucosal surfaces is associated with adverse events during pregnancy. The aim of this review is to investigate the link between vaginal microbiome alterations and gestational complication risk. Methods: This comprehensive literature review was performed using Medline and Scopus databases. The following search algorithm was used, “Pregnancy Complications” [Mesh] AND (Vagin*), and after the literature screening, 44 studies were included in the final review. Results: The studies that were included investigated the association between vaginal microbial composition and preterm birth, miscarriage, preeclampsia, ectopic pregnancy, gestational diabetes mellitus, chorioamnionitis, and preterm premature rupture of membranes. In most of the studies, it was well established that increased microbial diversity is associated with these conditions. Also, the depletion of Lactobacillus species is linked to most of the gestational complications, while the increased relative abundance and especially Lactobacillus crispatus may exert a protective effect in favor of the pregnant woman. Several pathogenic taxa including Gardnerella, Prevotella, Sneathia, Bacterial Vaginosis-Associated Bacteria-2, Atopobium, and Megasphera seem to be correlated to higher maternal morbidity. Conclusions: Vaginal microbiome aberrations seem to have an association with pregnancy-related adverse events, but more high-quality homogenous studies are necessary to reliably verify this link.
Full article
(This article belongs to the Section Obstetrics & Gynecology)
Open AccessArticle
A Complex Relationship between Quality of Life, Anxiety, and Depression among General Population during Second Year of COVID-19 Pandemic: A Population-Based Study
by
Danijela Radulovic, Srdjan Masic, Dejana Stanisavljevic, Dejan Bokonjic, Svetlana Radevic, Nina Rajovic, Nikola V. Milić, Ivana Simic Vukomanovic, Biljana Mijovic, Maja Vukovic, Milena Dubravac Tanaskovic, Mirka Jojic, Jelena Vladicic Masic, Dragan Spaic and Natasa M. Milic
J. Clin. Med. 2024, 13(13), 3874; https://doi.org/10.3390/jcm13133874 (registering DOI) - 30 Jun 2024
Abstract
Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental
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Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative co** was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive co** had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.
Full article
(This article belongs to the Special Issue The COVID-19 Pandemic and Mental Health: The Next Phase)
Open AccessArticle
Non-Motor Symptoms in Primary Familial Brain Calcification
by
Giulia Bonato, Paola Cimino, Francesca Pistonesi, Leonardo Salviati, Cinzia Bertolin and Miryam Carecchio
J. Clin. Med. 2024, 13(13), 3873; https://doi.org/10.3390/jcm13133873 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: Primary Familial Brain Calcification is a rare neurodegenerative disorder of adulthood characterized by calcium deposition in the basal ganglia and other brain areas; the main clinical manifestations include movement disorders, mainly parkinsonism. Non-motor symptoms are not well defined in PFBC. This work
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Background/Objectives: Primary Familial Brain Calcification is a rare neurodegenerative disorder of adulthood characterized by calcium deposition in the basal ganglia and other brain areas; the main clinical manifestations include movement disorders, mainly parkinsonism. Non-motor symptoms are not well defined in PFBC. This work aims at defining the burden of non-motor symptoms in PFBC. Methods: A clinical, genetic and neuropsychological evaluation of a cohort of PFBC patients, COMPASS-31 scale administration. Results: A total of 50 PFBC patients were recruited; in 25, the genetic test was negative; 10 carried mutations in SLC20A2 gene, 8 in MYORG, 3 in PDGFB, 1 in PDGFRB, 2 in JAM2 (single mutations), and one test is still ongoing. The main motor manifestation was parkinsonism. Headache was reported in 26% of subjects (especially in PDGFB mutation carriers), anxiety or depression in 62%, psychosis or hallucinations in 10–12%, sleep disturbances in 34%; 14% of patients reported hyposmia, 32% constipation, and 34% urinary disturbances. A neuropsychological assessment revealed cognitive involvement in 56% (sparing memory functions, to some extent). The COMPASS-31 mean score was 20.6, with higher sub-scores in orthostatic intolerance and gastrointestinal problems. MYORG patients and subjects with cognitive decline tended to have higher scores and bladder involvement compared to other groups. Conclusions: The presence of non-motor symptoms is frequent in PFBC and should be systematically assessed to better meet patients’ needs.
Full article
(This article belongs to the Special Issue Non-motor Symptoms in Movement Disorders)
Open AccessArticle
The Incidence and Outcomes of Major Limb Amputation in New Zealand from 2010 to 2021
by
Odette Hart, Oliver Bernau and Manar Khashram
J. Clin. Med. 2024, 13(13), 3872; https://doi.org/10.3390/jcm13133872 (registering DOI) - 30 Jun 2024
Abstract
Background: Major limb amputation (MLA) can be a common outcome due to severe peripheral artery disease (PAD) and diabetic foot disease (DFD), and it carries a significant mortality burden. In New Zealand (NZ), there is little documentation of the incidence rate and
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Background: Major limb amputation (MLA) can be a common outcome due to severe peripheral artery disease (PAD) and diabetic foot disease (DFD), and it carries a significant mortality burden. In New Zealand (NZ), there is little documentation of the incidence rate and mortality after MLA. The aim was to report the national crude and standardised rates and the mortality post MLA. Methods: This retrospective observational study included all MLAs that occurred within NZ from 1/1/2010 to 31/12/2021 due to DFD and/or PAD. Two national databases (National Minimum Dataset and the Australasian Vascular Audit) were utilised. The crude rates were calculated as cases per 100,000 in the NZ population per year including all ages (using the 2013 and 2018 NZ census figures). The age-standardised rates used the World Health Organization standard population. Post-operative mortality was calculated from the date of first hospitalisation for MLA. Results: From 2010 to 2021, there were 5293 MLA procedures in 4242 patients. On average, there were 8.5 MLAs per week and 441.1 MLAs annually. The overall crude rate was 9.44 per 100,000, and the standardised rate was 6.12 per 100,000. Over the 12 years, the crude rate decreased by 22% (p < 0.001), and the standardised rate decreased by 20.4% (p < 0.001). After MLA, the 30-day and 1-year mortality was 9.5% and 29.6%, respectively. From 2010 to 2021, the relative reduction in 30-day mortality was 45.1% (p < 0.001), and the reduction in 1-year mortality was 24.5% (p < 0.001). Increasing age, female sex and end-stage renal failure were predictors of 30-day and 1-year mortality. Conclusions: A considerable number of MLAs occur in NZ, with substantial perioperative mortality; however, the national incidence rates and mortality have improved over the last 12 years. This data might serve as benchmark to further reduce MLAs and improve patient outcomes.
Full article
(This article belongs to the Special Issue Clinical Advances in Vascular and Endovascular Surgery)
Open AccessReview
Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD) after Liver Transplantation: A Narrative Review of an Emerging Issue
by
Alberto Savino, Alessandro Loglio, Flavia Neri, Stefania Camagni, Luisa Pasulo, Maria Grazia Lucà, Roberto Trevisan, Stefano Fagiuoli and Mauro Viganò
J. Clin. Med. 2024, 13(13), 3871; https://doi.org/10.3390/jcm13133871 (registering DOI) - 30 Jun 2024
Abstract
The development of steatotic liver disease after liver transplant (LT) is widely described, and epidemiological data have revealed an increased incidence in recent times. Its evolution runs from simple steatosis to steatohepatitis and, in a small proportion of patients, to significant fibrosis and
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The development of steatotic liver disease after liver transplant (LT) is widely described, and epidemiological data have revealed an increased incidence in recent times. Its evolution runs from simple steatosis to steatohepatitis and, in a small proportion of patients, to significant fibrosis and cirrhosis. Apparently, post-LT steatotic disease has no impact on the recipient’s overall survival; however, a higher cardiovascular and malignancy burden has been reported. Many donors’ and recipients’ risk factors have been associated with this occurrence, although the recipient-related ones seem of greater impact. Particularly, pre- and post-LT metabolic alterations are strictly associated with steatotic graft disease, sharing common pathophysiologic mechanisms that converge on insulin resistance. Other relevant risk factors include genetic variants, sex, age, baseline liver diseases, and immunosuppressive drugs. Diagnostic evaluation relies on liver biopsy, although non-invasive methods are being increasingly used to detect and monitor both steatosis and fibrosis stages. Management requires a multifaceted approach focusing on lifestyle modifications, the optimization of immunosuppressive therapy, and the management of metabolic complications. This review aims to synthesize the current knowledge of post-LT steatotic liver disease, focusing on the recent definition of metabolic-dysfunction-associated steatotic liver disease (MASLD) and its metabolic and multisystemic concerns.
Full article
(This article belongs to the Special Issue Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Current Concepts and Future Challenges)
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Open AccessCase Report
A New Histology-Based Prognostic Index for Aggressive T-Cell lymphoma: Preliminary Results of the “TCL Urayasu Classification”
by
Hideaki Nitta, Haruko Takizawa, Toru Mitsumori, Hiroko Iizuka-Honma, Tomonori Ochiai, Chiho Furuya, Yoshihiko Araki, Maki Fujishiro, Shigeki Tomita, Akane Hashizume, Tomohiro Sawada, Kazunori Miyake, Mitsuo Okubo, Yasunobu Sekiguchi, Miki Ando and Masaaki Noguchi
J. Clin. Med. 2024, 13(13), 3870; https://doi.org/10.3390/jcm13133870 (registering DOI) - 30 Jun 2024
Abstract
Background: Aggressive mature T-cell lymphoma (TCL) is a disease that carries a poor prognosis. Methods: We analyzed the expression of 22 tumor cell functional proteins in 16 randomly selected patients with TCL. Immunohistochemistry was performed in paraffin-embedded tumor tissue sections to determine the
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Background: Aggressive mature T-cell lymphoma (TCL) is a disease that carries a poor prognosis. Methods: We analyzed the expression of 22 tumor cell functional proteins in 16 randomly selected patients with TCL. Immunohistochemistry was performed in paraffin-embedded tumor tissue sections to determine the protein expression statuses in tumor cells. Results: Glucose-regulated protein 94 (GRP94), a protein that serves as a pro-survival component under endoplasmic reticulum (ER) stress in the tumor microenvironment, was significantly associated with a shortened survival. Furthermore, significant differences were observed when GRP94 was combined with six other factors. The six factors were (1) programmed cell death-ligand 1 (PD-L1); (2) programmed cell death 1 (PD-1); (3) aldo-keto reductase family 1 member C3 (AKR1C3); (4) P53, a tumor suppressor; (5) glucose-regulated protein 78 (GRP78), an ER stress protein; and (6) thymidine phosphorylase (TP). Based on the combination of GRP94 and the six other factors expressed in the tumors, we propose a new prognostic classification system for TCL (TCL Urayasu classification). Group 1 (relatively good prognosis): GRP94-negative (n = 6; median OS, 88 months; p < 0.01); Group 2 (poor prognosis): GRP94-positive, plus expression of two of the six factors mentioned above (n = 5; median OS, 25 months; p > 0.05); and Group 3 (very poor prognosis): GRP94-positive, plus expression of at least three of the six factors mentioned above (n = 5; median OS, 10 months; p < 0.01). Conclusions: Thus, the TCL Urayasu prognostic classification may be a simple, useful, and innovative classification that also explains the mechanism of resistance to treatment for each functional protein. If validated in a larger number of patients, the TCL Urayasu classification will enable a targeted treatment using selected inhibitors acting on the abnormal protein found in each patient.
Full article
(This article belongs to the Special Issue Hematologic Malignancies: Treatment Strategies and Future Challenges)
Open AccessSystematic Review
The Effects of Sarcopenia on Overall Survival and Postoperative Complications of Patients Undergoing Hepatic Resection for Primary or Metastatic Liver Cancer: A Systematic Review and Meta-Analysis
by
Alexandros Giakoustidis, Menelaos Papakonstantinou, Paraskevi Chatzikomnitsa, Areti Danai Gkaitatzi, Petros Bangeas, Panagiotis Dimitrios Loufopoulos, Eleni Louri, Athanasia Myriskou, Ioannis Moschos, Diomidis Antoniadis, Dimitrios Giakoustidis and Vasileios N. Papadopoulos
J. Clin. Med. 2024, 13(13), 3869; https://doi.org/10.3390/jcm13133869 (registering DOI) - 30 Jun 2024
Abstract
Background: Colorectal cancer is the third most common cancer worldwide, and 20–30% of patients will develop liver metastases (CRLM) during their lifetime. Hepatocellular carcinoma (HCC) is also one of the most common cancers worldwide with increasing incidence. Hepatic resection represents the most effective
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Background: Colorectal cancer is the third most common cancer worldwide, and 20–30% of patients will develop liver metastases (CRLM) during their lifetime. Hepatocellular carcinoma (HCC) is also one of the most common cancers worldwide with increasing incidence. Hepatic resection represents the most effective treatment approach for both CRLM and HCC. Recently, sarcopenia has gained popularity as a prognostic index in order to assess the perioperative risk of hepatectomies. The aim of this study is to assess the effects of sarcopenia on the overall survival (OS), complication rates and mortality of patients undergoing liver resections for HCC or CRLM. Methods: A systematic literature search was performed for studies including patients undergoing hepatectomy for HCC or CRLM, and a meta-analysis of the data was performed. Results: Sarcopenic patients had a significantly lower 5-year OS compared to non-sarcopenic patients (43.8% vs. 63.6%, respectively; p < 0.01) and a significantly higher complication rate (35.4% vs. 23.1%, respectively; p = 0.002). Finally, no statistical correlation was found in mortality between sarcopenic and non-sarcopenic patients (p > 0.1). Conclusions: Sarcopenia was significantly associated with decreased 5-year OS and increased morbidity, but no difference was found with regard to postoperative mortality.
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(This article belongs to the Special Issue Preventive, Diagnostic and Therapeutic Strategies for Abdominal Surgery Complications)
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Open AccessArticle
Influence of Education on Dental Anxiety and Fear in Mental Disorders after Viewing a Molar Extraction in Three Types of Mental Disorder Compared to Persons with No Mental Disorder
by
Elena Bermúdez-Bejarano, Juan-Antonio Bermúdez-Sánchez, Francisco-José Ruiz-Rey, María Baus-Domínguez, María-Ángeles Serrera-Figallo, José-Luis Gutiérrez-Pérez and Daniel Torres-Lagares
J. Clin. Med. 2024, 13(13), 3868; https://doi.org/10.3390/jcm13133868 (registering DOI) - 30 Jun 2024
Abstract
Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical
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Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18–70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.
Full article
(This article belongs to the Section Mental Health)
Open AccessReview
Identifying Gaps in the Treatment Guidelines for Hepatitis C in Peru to Meet International Standards: A Narrative Review
by
Jose A. Gonzales-Zamora, Carlos Quispe-Vicuña, Martín E. Reategui-Garcia, Julieta M. Araoz-Salinas, Fabricio Ccami-Bernal, Noelia Morocho-Alburqueque, Jian Pierre Espinoza-Herreros, Josue Layme, Gabriel Aquino-Sandoval, Victor Y. Melt Campos and Jorge Alave
J. Clin. Med. 2024, 13(13), 3867; https://doi.org/10.3390/jcm13133867 (registering DOI) - 30 Jun 2024
Abstract
Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to
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Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to update these guidelines. We reviewed the most recent recommendations of the international guidelines and compared them with the current Peruvian guidelines. We found major differences, such as the use of Glecaprevir/Pibrentasvir as a first-line therapy, which is contemplated in the World Health Organization guideline, and recommended by American and European guidelines, but is not considered in the Peruvian guidelines. Another crucial difference lies in the management of patients with chronic kidney disease, who are treated nowadays with a variety of direct-acting antivirals, with no restrictions on the use of Sofosbuvir-based regimens in first-world countries, an approach that has not been adopted in Peru. We believe that standardization of the recommendations of the Peruvian guidelines is imperative, including the new therapeutic strategies that have emerged in recent years. We also suggest conducting a cost effectiveness analysis in the Peruvian context to allow for the implementation of new antivirals, and to achieve a better control of hepatitis C in the country.
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(This article belongs to the Section Clinical Guidelines)
Open AccessStudy Protocol
Ionizing Radiation-Induced Oxidative Stress in Computed Tomography—Effect of Vitamin C on Prevention of DNA Damage: PREVIR-C Randomized Controlled Trial Study Protocol
by
Camilo G. Sotomayor, Camila González, Miki Soto, Nicolás Moreno-Bertero, Claudina Opazo, Baltasar Ramos, Gonzalo Espinoza, Álvaro Sanhueza, Gonzalo Cárdenas, Sebastián Yévenes, Jorge Díaz-Jara, José de Grazia, Marcia Manterola, Daniel Castro, Abraham A. I. J. Gajardo and Ramón Rodrigo
J. Clin. Med. 2024, 13(13), 3866; https://doi.org/10.3390/jcm13133866 (registering DOI) - 30 Jun 2024
Abstract
Exposure to ionizing radiation (IR) is inevitable in various X-ray imaging examinations, with computed tomography (CT) being a major contributor to increased human radiation exposure. Ionizing radiation may cause structural damage to macromolecules, particularly DNA, mostly through an indirect pathway in diagnostic imaging.
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Exposure to ionizing radiation (IR) is inevitable in various X-ray imaging examinations, with computed tomography (CT) being a major contributor to increased human radiation exposure. Ionizing radiation may cause structural damage to macromolecules, particularly DNA, mostly through an indirect pathway in diagnostic imaging. The indirect pathway primarily involves the generation of reactive oxygen species (ROS) due to water radiolysis induced by IR, leading to DNA damage, including double-strand breaks (DSB), which are highly cytotoxic. Antioxidants, substances that prevent oxidative damage, are proposed as potential radioprotective agents. This Study Protocol article presents the rationale for selecting vitamin C as a preventive measure against CT-associated IR-induced DNA damage, to be investigated in a randomized placebo-controlled trial, with a full in vivo design, using an oral easy-to-use schedule administration in the outpatient setting, for the single CT examination with the highest total global IR dose burden (contrast-enhanced abdomen and pelvis CT). The study also aims to explore the mediating role of oxidative stress, and it has been written in adherence to the Standard Protocol Items recommendations.
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(This article belongs to the Special Issue New Insights into Diagnostic and Interventional Radiology)
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Open AccessArticle
Changes in the Lipid Asset of HIV/HCV Patients after a Successful Course of Direct-Acting Antivirals
by
Anna Maria Spera, Valeria Conti, Graziamaria Corbi, Tiziana Ascione, Michele Ciccarelli, Alfonso Masullo, Gianluigi Franci and Pasquale Pagliano
J. Clin. Med. 2024, 13(13), 3865; https://doi.org/10.3390/jcm13133865 (registering DOI) - 30 Jun 2024
Abstract
Background: Highly Active Antiretroviral Therapy (HAART) for HIV infection and Direct-Acting Antivirals (DAA) for HCV infection currently represent the main treatment options for HIV/HCV co-infected patients. However, HAART has been associated with increased lipids. This study aimed to evaluate lipid profile changes after
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Background: Highly Active Antiretroviral Therapy (HAART) for HIV infection and Direct-Acting Antivirals (DAA) for HCV infection currently represent the main treatment options for HIV/HCV co-infected patients. However, HAART has been associated with increased lipids. This study aimed to evaluate lipid profile changes after the DAA cycle in HIV/HCV co-infected patients undergoing HAART/DAA therapy. Methods: A prospective, longitudinal, observational study among HIV/HCV co-infected patients undergoing HAART/DAA treatment was conducted at the Infectious Diseases Unit of the University Hospital of Salerno. Inclusion criteria were age > 18 years, written informed consent, completion of the DAA cycle, and virologic suppression on HAART. Changes in the lipid profile were analyzed from baseline during and after DAA therapy at 12, 24, and 48 weeks after the sustained virologic response (SVR). A t-test was used to compare continuous variables. An analysis of variance was performed for each antiretroviral drug and genotype. Results: Fifty-four HIV/HCV patients (men/women n. 34/20 [68/32%], median age 56 years), all naïve to HCV therapy, were enrolled. HCV infection was caused by genotype 1 in 55% of cases and by genotype 3 in 29%. An increase in total cholesterol was recorded after the DAA treatment (from 165.03 ± 46.5 to 184.7 ± 44.9 mg/dL, p < 0.0001), after 12, 24, and 48 weeks, and in LDL-C at 24 weeks follow-up (at baseline 86.7 ± 34 mg/dl to 103.4 ± 41.38 mg/dl, p < 0.0001). Conclusions: Changes in the lipid profile after combined DAA/HAART treatment represent an important prognostic index. Further evaluation of cardiovascular-associated risk is necessary to implement appropriate prevention strategies.
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(This article belongs to the Section Infectious Diseases)
Open AccessArticle
Long-Term Persistence Rate of Secukinumab in Psoriatic Patients: A Six-Year Multicenter, Real-World Experience, Retrospective Study
by
Marco Galluzzo, Emanuele Trovato, Marina Talamonti, Giacomo Caldarola, Lucia Di Nardo, Laura Lazzeri, Cristina Mugheddu, Martina Burlando, Riccardo Balestri, Nicoletta Bernardini, Gabriele Biondi, Laura Vellucci, Filomena Russo, Clara De Simone, Claudia Paganini, Giulia Rech, Emanuele Claudio Cozzani, Laura Atzori, Maria Antonia Montesu, Concetta Potenza, Andrea Chiricozzi and Pietro Rubegniadd
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J. Clin. Med. 2024, 13(13), 3864; https://doi.org/10.3390/jcm13133864 (registering DOI) - 30 Jun 2024
Abstract
Background: Psoriatic disease, a chronic immune-mediated systemic inflammatory condition, significantly impairs patients’ quality of life. The advent of highly targeted biological therapies has transformed treatment strategies, emphasizing the importance of selecting the most effective and cost-efficient option. Secukinumab, an IL-17A inhibitor, has
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Background: Psoriatic disease, a chronic immune-mediated systemic inflammatory condition, significantly impairs patients’ quality of life. The advent of highly targeted biological therapies has transformed treatment strategies, emphasizing the importance of selecting the most effective and cost-efficient option. Secukinumab, an IL-17A inhibitor, has demonstrated efficacy and safety in treating moderate-to-severe plaque psoriasis (PsO). However, long-term real-world data on its effectiveness and persistence rate are limited. Methods: This retrospective study, conducted across eight Italian dermatology centers, aimed to evaluate the 6-year persistence rate and effectiveness of secukinumab in patients with PsO. Additionally, the study investigated the onset of psoriatic arthritis during treatment. Results: Overall, 166 adult patients were analyzed. Their median age was 53.9 years. The mean BMI was 26.5. Of the 166 patients, 64 were bio-experienced while 102 were bio-naïve. A progressive reduction in PsO severity measured by PASI scores over 6 years of treatment was revealed: the PASI score decreased from a baseline value of 18.1 (±9.1) to 0.7 (±1.6) after 6 years of follow-up. Adverse events, including mucocutaneous fungal infections and cardiovascular disturbances, were reported in 19.9% of patients. The persistence rate was 86.8% at 24 months, decreasing to 66.4% at 72 months. Psoriatic arthritis onset during treatment was observed in 15 (9.0%) of patients. Conclusions: This study highlights the sustained effectiveness and favorable safety profile of secukinumab over 6 years, providing valuable real-world evidence. Understanding the long-term persistence rate and predictors of discontinuation could help clinicians optimize treatment decisions and improve patient outcomes in PsO management. We found that the absence of scalp PsO, no involvement of the genital area and normal weight were the best factors of persistence in secukinumab treatment in the long term.
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(This article belongs to the Special Issue Modern Approaches to Psoriasis: Current Treatments and Future Possibilities)
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Open AccessArticle
Comparison between Classical- and Rotational-Mechanical-Chair-Assisted Maneuvers in a Population of Patients with Benign Paroxysmal Positional Vertigo
by
Marta Chaure-Cordero, Maria Garrote-Garrote, Jonathan Esteban-Sánchez, Paula Morales-Chacchi, Marina Del Valle-Díaz and Eduardo Martin-Sanz
J. Clin. Med. 2024, 13(13), 3863; https://doi.org/10.3390/jcm13133863 (registering DOI) - 30 Jun 2024
Abstract
Introduction: Benign paroxysmal positional vertigo (BPPV) stands as the most common cause of peripheral vertigo. Its treatment with repositioning maneuvers on an examination table is highly effective. However, patients with back or neck problems, paraplegia, or other conditions face challenges with these
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Introduction: Benign paroxysmal positional vertigo (BPPV) stands as the most common cause of peripheral vertigo. Its treatment with repositioning maneuvers on an examination table is highly effective. However, patients with back or neck problems, paraplegia, or other conditions face challenges with these maneuvers, potentially experiencing longer healing times and creating additional difficulties for physicians diagnosing and treating BPPV in everyday practice. The emergence of mechanical rotational chairs (MRCs) offers a more convenient alternative for performing these maneuvers. Objectives: The primary objective was to compare the effectiveness of maneuvers on the examination table with those on MRCs in BPPV patients diagnosed in the emergency room and randomly classified into one of the treatment options. The secondary objectives included a comparison of patient quality of life during BPPV episodes and after their resolution and an analysis of recurrences and associated risk factors. Methods: This was a cohort study on sixty-three patients diagnosed with BPPV in the emergency department. Patients were classified into two cohorts depending on diagnostic and treatment maneuvers (MRC or conventional repositioning maneuvers (CRMs)) and received weekly follow-ups until positioning maneuvers became negative. Subsequent follow-ups were conducted at 1 month, 3 months, and 6 months after the resolution of vertigo. Patients were classified into two groups based on their assigned treatment method. Results: Thirty-one patients were treated with CRMs and 32 with TRV. Mean age was 62.29 ± 17.67 years and the most affected canal was the PSC (96.8%). The mean number of required maneuvers was two, while 55.56% only required one maneuver until resolution. Recurrence was present in 26.98% of the patients during the 6-month follow-up. Comparing both cohorts, there were no statistically significant differences between treatments (TRV vs. CRM) regarding the number of maneuvers, number of recurrences, and days until remission of BPPV. Dizziness Handicap Inventory and Visual Analogue Scale values decreased considerably after BPPV resolution, with no statistically significant differences between the groups. Age was identified as a covariable in the number of maneuvers and days until BPPV resolution, showing that an increase in age implies a greater need of maneuvers. Conclusions: There was no difference between the means of treatment for BPPV in our population ot There was no difference between the groups of treatments for BPPV in our population. The quality of life of patients improved six months after the resolution of BPPV, regardless of the treatment applied.
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(This article belongs to the Special Issue Clinical Insights into Vestibular Disorders)
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Open AccessArticle
Echocardiography-Derived Hemodynamic Forces Are Associated with Clinical Outcomes in Patients with Non-Ischemic Dilated Cardiomyopathy
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Marco Cesareo, Eduard Ródenas-Alesina, Andrea Guala, Jordi Lozano-Torres, Guillem Casas, Fabrizio Vallelonga, Lorenzo Airale, Ignacio Ferreira-González, Alberto Milan and Jose F. Rodriguez-Palomares
J. Clin. Med. 2024, 13(13), 3862; https://doi.org/10.3390/jcm13133862 (registering DOI) - 30 Jun 2024
Abstract
Introduction: Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by a reduced left ventricular (LV) ejection fraction (LVEF, <50%) and a high risk for heart failure (HF) and death. Echocardiography-derived hemodynamic forces (HDFs) may provide important information on LV mechanics, but their prognostic value
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Introduction: Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by a reduced left ventricular (LV) ejection fraction (LVEF, <50%) and a high risk for heart failure (HF) and death. Echocardiography-derived hemodynamic forces (HDFs) may provide important information on LV mechanics, but their prognostic value is unknown. Aim: To explore the features of echocardiography-derived HDFs in NIDCM and their association with clinical endpoints. Methods: Asymptomatic, non-hospitalized NIDCM patients free from coronary artery disease and moderate or severe valvular heart disease were included in this single-center observational retrospective longitudinal study. Those with atrial fibrillation and a follow-up <12 months were excluded. Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death, HF hospitalization, and ambulatory intravenous diuretics administration. LV HDFs were analyzed with a prototype software. Apex-base (HDFs-ab), lateral-septal (HDFs-ls), and HDFs-angle were computed. Results: Ninety-seven patients were included, sixty-seven (69%) were males, mean age was 62 ± 14 years, and mean LVEF was 39.2 ± 8.6%. During a median follow-up of 4.2 (3.1–5.1) years, 19 (20%) patients experienced MACE. These patients had a higher HDFs-angle (71.0 (67.0–75.0) vs. 68.0 (63.0–71.0)°, p = 0.005), lower HDFs-ls (1.36 (1.01–1.85) vs. 1.66 ([1.28–2.04])%, p = 0.015), but similar HDFs-ab (5.02 (4.39–6.34) vs. 5.66 (4.53–6.78)%, p = 0.375) compared to those without MACE. in a Cox regression analysis, HDFs-angle (HR 1.16 (95%-CI 1.04–1.30), p = 0.007) was associated with MACE, while other conventional echocardiography parameters, including LVEF and LV longitudinal strain, were not. Conclusions: HDFs-angle is associated with clinical endpoints in NIDCM. A higher HDFs-angle may be a marker of impaired myocardial performance in patients with reduced LVEF.
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(This article belongs to the Special Issue Application of Echocardiography in the Diagnosis of Cardiovascular Diseases)
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Open AccessArticle
Seven-Year Longitudinal Study: Clinical Evaluation of Knee Osteoarthritic Patients Treated with Mesenchymal Stem Cells
by
Dusko Spasovski, Vesna Spasovski, Zoran Bascarevic, Maja Stojiljkovic, Marina Andjelkovic and Sonja Pavlovic
J. Clin. Med. 2024, 13(13), 3861; https://doi.org/10.3390/jcm13133861 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: Numerous studies have demonstrated the safety and efficacy of intraarticular stem cell injections for treating osteoarthritic knee joints, reporting symptom reduction and pain relief within a few months of treatment. Here, we report the results of a 7-year follow-up after a
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Background/Objectives: Numerous studies have demonstrated the safety and efficacy of intraarticular stem cell injections for treating osteoarthritic knee joints, reporting symptom reduction and pain relief within a few months of treatment. Here, we report the results of a 7-year follow-up after a single intraarticular injection of 0.5–1 × 107 autologous adipose tissue-derived mesenchymal stem cells in patients with OA (Kellgren-Lawrence grade 2 to 4). Methods: Nine patients were treated, and two patients had bilateral disease. Patients were evaluated clinically and radiologically using X-ray and MRI. A comprehensive statistical analysis was undertaken to evaluate the obtained results. Results: All clinical scores and range of motion significantly improved within the first six months after injection. At the 18-month time point, a significant improvement in cartilage structure was observed on MRI while X-ray showed no changes in subchondral bone of distal femur and proximal tibia. At the 60-month time point, the clinical scores were still improved compared to baseline, except for the range of motion, which decreased almost back to the baseline level. At 84 months, the clinical scores decreased significantly toward the baseline level, but the MRI structural characteristics of cartilage still remained significantly better than those measured at baseline. Conclusions: Adipose tissue-derived stem cell therapy has substantial long-term clinical effects on patients with knee osteoarthritis.
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(This article belongs to the Special Issue Latest Advances in Clinical Diagnosis and Treatment of Hip and Knee Osteoarthritis)
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Open AccessArticle
The Cardiac Pulsed Wave Doppler Pattern of the Common Femoral Vein in Diagnosing the Likelihood of Severe Pulmonary Hypertension: Results from a Prospective Multicentric Study
by
Marta Torres-Arrese, Pablo Barberá-Rausell, Jie-Wei Oscar Li-Zhu, Rocío Salas-Dueñas, Alma Elena Real-Martín, Arantzazu Mata-Martínez, Begoña Gonzalo-Moreno, Joaquín Hernández Núñez, Davide Luordo, Juan Gabriel Sánchez Cano, Tomás Villén Villegas, Luis Caurcel-Díaz, Gonzalo García de Casasola-Sánchez and Yale Tung-Chen
J. Clin. Med. 2024, 13(13), 3860; https://doi.org/10.3390/jcm13133860 (registering DOI) - 30 Jun 2024
Abstract
Background and Objectives: Pulmonary hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the likelihood of pulmonary hypertension (LPH) using advanced echocardiography before proceeding to right heart catheterization. This study proposed using
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Background and Objectives: Pulmonary hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the likelihood of pulmonary hypertension (LPH) using advanced echocardiography before proceeding to right heart catheterization. This study proposed using the common femoral vein (CFV), an accessible vein that reflects right atrial pressure, as an alternative method to assess the high likelihood of pulmonary hypertension (H-LPH). Materials and Methods: This prospective observational study included 175 emergency patients from three hospitals. Ultrasound assessed the pulsed wave Doppler (PW-Doppler) morphology of the CFV. This diagnostic yield for H-LPH was evaluated alongside traditional ultrasound parameters (right-to-left ventricular basal diameter ratio greater than 1 (RV > LV), septal flattening, right ventricular outflow acceleration time (RVOT) of less than 105 ms and/or mesosystolic notching, pulmonary artery diameter greater than the aortic root (AR) diameter or over 25 mm, early pulmonary regurgitation maximum velocity > 2.2 m/s; TAPSE/PASP less than 0.55, inferior vena cava (IVC) diameter over 21 mm with decreased inspiratory collapse, and right atrial (RA) area over 18 cm2). Results: The CFV’s PW-Doppler cardiac pattern correlated strongly with H-LPH, showing a sensitivity (Sn) of 72% and a specificity (Sp) of 96%. RA dilation and TAPSE/PASP < 0.55 also played significant diagnostic roles. Conclusions: The CFV’s PW-Doppler cardiac pattern is an effective indicator of H-LPH, allowing reliable exclusion of this condition when absent. This approach could simplify initial LPH evaluation in emergency settings or where echocardiographic resources are limited.
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(This article belongs to the Special Issue Emergency Ultrasound: State of the Art and Perspectives)
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Open AccessArticle
The Optimal Lowest Instrumented Vertebra to Prevent the Distal Adding-On Phenomenon in Patients Undergoing Selective Thoracic Fusion for Adolescent Idiopathic Scoliosis with Lenke Type 1A and 1B Curves: Comparison of Nine Selection Criteria
by
Se-Jun Park, **-Sung Park, Dong-Ho Kang and Chong-Suh Lee
J. Clin. Med. 2024, 13(13), 3859; https://doi.org/10.3390/jcm13133859 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: There is no solid consensus regarding which lowest instrumented vertebra (LIV) selection criterion is best to prevent distal adding-on (DA) after adolescent idiopathic scoliosis (AIS) surgery. This study aims to search out the LIV selection criteria in the literature and to
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Background/Objectives: There is no solid consensus regarding which lowest instrumented vertebra (LIV) selection criterion is best to prevent distal adding-on (DA) after adolescent idiopathic scoliosis (AIS) surgery. This study aims to search out the LIV selection criteria in the literature and to compare the ability of each LIV selection criterion to prevent DA in patients with AIS. Methods: Patients who underwent thoracic fusion for AIS of Lenke type 1A or 1B were included in this study. Nine criteria for LIV selection were found in a literature review. For each patient, whether the postoperative actual location of LIV was met with the suggested locations of the LIV was assessed. The preventive ability of nine criteria against DA was evaluated using logistic regression analysis. The patients who met the LIV selection criteria but developed DA were investigated. Results: The study cohort consisted of 145 consecutive patients with a mean age of 14.8 years. The criteria of Suk (OR = 0.267), Parisini (OR = 0.230), Wang (OR = 0.289), and Qin (OR = 0.210) showed a significantly decreased risk of DA if the LIV selection criterion was chosen at each suggested landmark. As the additional levels were fused, there was no statistically significant benefit in further reducing the risk of DA. Among the patients who met each criterion, the incidence of DA was lower in criteria by Takahashi (5.9%), Qin (7.1%), and King (7.4%) than the others. Conclusions: Qin’s criterion, using the substantially touching vertebra concept, has the highest preventive ability against DA development. Extending the instrumentation further distal to this suggested LIV criterion did not add further benefit.
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(This article belongs to the Special Issue Advances in Scoliosis, Spinal Deformity and Other Spinal Disorders)
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Open AccessArticle
Procedural Outcome and 1-Year Follow-Up of Young Patients Undergoing Implantable Cardioverter–Defibrillator Implantation—Insights from the German DEVICE I+II Registry
by
Da-Un Chung, Matthias Hochadel, Jochen Senges, Thomas Kleemann, Lars Eckardt, Johannes Brachmann, Gerhard Steinbeck, Robert Larbig, Christian Butter, Thomas Uher, Stephan Willems and Samer Hakmi
J. Clin. Med. 2024, 13(13), 3858; https://doi.org/10.3390/jcm13133858 (registering DOI) - 30 Jun 2024
Abstract
Background: The number of young patients receiving ICDs or CRT-Ds has been increasing in recent decades and understanding the key characteristics of this special population is paramount to optimized patient care. Methods: The DEVICE I+II registry prospectively enrolled patients undergoing ICD/CRT-D
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Background: The number of young patients receiving ICDs or CRT-Ds has been increasing in recent decades and understanding the key characteristics of this special population is paramount to optimized patient care. Methods: The DEVICE I+II registry prospectively enrolled patients undergoing ICD/CRT-D implantation or revision from 50 German centers between 2007 and 2014 Data on patient characteristics, procedural outcome, adverse events, and mortality during the initial stay and 1-year follow-up were collected. All patients under the age of 45 years were identified and included in a comparative analysis with the remaining population. Results: A total number of 5313 patients were enrolled into the registry, of which 339 patients (6.4%) were under the age of 45 years. Mean age was 35.0 ± 8.2 vs. 67.5 ± 9.7 years, compared to older patients (≥45 years). Young patients were more likely to receive an ICD (90.9 vs. 69.9%, p < 0.001) than a CRT-D device (9.1 vs. 30.1%). Coronary artery disease was less common in younger patients (13.6 vs. 63.9%, p < 0.001), whereas hypertrophic cardiomyopathy (10.9 vs. 2.7%, p < 0.001) and primary cardiac electrical diseases (11.2 vs. 1.5%, p < 0.001) were encountered more often. Secondary preventive ICD was more common in younger patients (51.6 vs. 39.9%, p < 0.001). Among those patients, survival of sudden cardiac death (66.7 vs. 45.4%, p < 0.001) due to ventricular fibrillation (60.6 vs. 37.9%, p < 0.001) was the leading cause for admission. There were no detectable differences in postoperative complications requiring intervention (1.5 vs. 1.9%, p = 0.68) or in-hospital mortality (0.0 vs. 0.3%, p = 0.62). Median follow-up duration was 17.9 [13.4–22.9] vs. 16.9 [13.1–23.1] months (p = 0.13). In younger patients, device-associated complications requiring revision were more common (14.1 vs. 8.3%, p < 0.001) and all-cause 1-year-mortality after implantation was lower (2.9 vs. 7.3%, p = 0.003; HR 0.39, 95%CI: 0.2–0.75) than in older patients. Conclusions: Young patients < 45 years of age received defibrillator therapy more often for secondary prevention. Rates for periprocedural complications and in-hospital mortality were very low and without differences between groups. Young patients have lower mortality during follow-up but experienced a higher rate of postoperative complications requiring revision, potentially due to a more active lifestyle.
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(This article belongs to the Section Cardiology)
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Open AccessArticle
Evaluating Factor VIII Concentrates Using Clot Waveform Analysis
by
Hideo Wada, Katsuya Shiraki, Takeshi Matsumoto, Hideto Shimpo, Yumi Sakano, Hiroko Nishii, Shigehisa Tamaki, Kei Suzuki, Isao Tawara, Yoshiki Yamashita and Motomu Shimaoka
J. Clin. Med. 2024, 13(13), 3857; https://doi.org/10.3390/jcm13133857 (registering DOI) - 30 Jun 2024
Abstract
Background/Objectives: FVIII reagent activity varies across different assays, as well as activated partial thromboplastin time (APTT) reagents. The hemostatic ability of various FVIII reagents was examined via clot waveform analysis (CWA). Methods: APTT was measured using 12 APTT reagents, a small
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Background/Objectives: FVIII reagent activity varies across different assays, as well as activated partial thromboplastin time (APTT) reagents. The hemostatic ability of various FVIII reagents was examined via clot waveform analysis (CWA). Methods: APTT was measured using 12 APTT reagents, a small amount of tissue factor-induced FIX activation (sTF/FIXa) and a small amount of thrombin time (sTT) in order to examine 10 FVIII reagents and reference plasma (RP) using CWA. FVIII activity was measured using CWA-APTT, a chromogenic assay, or CWA-sTT. Results: Although the peak time (PT) and peak height (PH) of the CWA-APTT were markedly different in different FVIII reagents using several APTT reagents, the PTs of CWA-APTT were generally normal or shortened and the PHs of CWA-APTT were generally lower than those of RP. The FVIII activity varied, as evaluated using APTT, and was higher when using the CWA-sTT method than the APTT or chromogenic methods. CWA-sTT showed an elevated second peak of first DPH in all FVIII reagents, and both CWA-sTF/FIXa and CWA-sTT were enhanced using APTT reagents. Conclusions: Our evaluation of the hemostatic ability of FVIII reagents varied among APTT reagents. CWA-sTT can be used to further evaluate the hemostatic ability of an FVIII concentrate based on thrombin burst.
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(This article belongs to the Section Hematology)
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