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Prekallikrein (PK) is a contact factor of the intrinsic pathway of the coagulation cascade. Patients with PK deficiency usually do not show bleeding tendency despite prolonged activated partial thromboplastin time (aPTT). Here we report two cases of male patients in their seventies, both with a prolonged aPTT detected at a pre-operative screening. The aPTT correction after 1:1 mixing with normal pool plasma (NPP) indicated a coagulation factor deficiency; however, factors XII, XI, IX and VIII activities were normal. The aPTT test was then performed increasing the pre-incubation time of the patient’s plasma. This resulted in a significant shortening of the aPTT. The PK deficiency was ultimately confirmed by direct measurement of PK plasma activity. This experience shows that PK deficiency should be considered for asymptomatic patients with prolonged aPTT and that, whenever a PK deficient plasma is not available, the diagnosis can be correctly obtained through a simple modification of the procedure of the aPTT test. [ABSTRACT FROM AUTHOR]

Clinical research is vital in supporting evidence-based practice. However, several barriers make participation in research difficult. We performed a survey to evaluate the attitude to research of the members of the Italian Anticoagulation Clinics. The survey includes 19 closed questions on the perception of participating in research and exploring the benefit that health professionals wish to obtain. A total of 167 questionnaires were returned from 97/220 (44.1%) Centers, of which 89.7% were not academic. Participants (median age 56 years, range 29-75y; 56.3% females) were equally distributed all over the country; 151/167 (90.4%) of respondents believe that participating in research helps to reduce the routine of their work and allows a better quality of work, 72/167 (43.1%) complain heavy workload. More than 74% of respondents would like to participate in scientific meetings, without difference in relation to age. Instead, inclusion in the authorship of a scientific paper is of relevance for 75.6% of respondents =50 years and for 65.2% of respondents >50 years. A substantial positive attitude towards research was evident, suggesting that independent scientific societies could be of valuable support for the growth of research culture. [ABSTRACT FROM AUTHOR]

Copyright of Saúde e Pesquisa is the property of Saude e Pesquisa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. The recent spreadout of the COVID-19 pandemic requires a re-organization of Anticoagulation Clinics to prevent person-to-person viral diffusion and continue to offer the highest possible quality of assistance to patients. In this paper, based on the Italian Federation of Anticoagulation Clinics statements, we offer some advice aimed at improving patient care during COVID-19 pandemic, with particular regard to the lockdown and reopening periods. We give practical guidance regarding the following points: (1) re-thinking the AC organization, (2) managing patients on anticoagulants when they become infected by the virus, (3) managing anticoagulation surveillance in non-infected patients during the lockdown period, and (4) organizing the activities during the reopening phases. [ABSTRACT FROM AUTHOR]

Prothrombin fragment F1 + 2 (F1 + 2) and thrombin–antithrombin (TAT) have been assessed in antiphospholipid syndrome (APS) but without evaluating a direct relationship with antiphospholipid (aPL) antibody titers. This article aims to investigate a direct relationship between aPL and F1 + 2 and perform a systematic review and meta-analysis of F1 + 2 and TAT in APS. Systematic search was performed using EMBASE and PubMed databases from January 1982 to December 2018 and random effects meta-analyses for continuous outcomes. This is a cross-sectional case–control study; immunoglobulin G/immunoglobulin M (IgG/IgM) anticardiolipin (aCL) anti-β 2 -glycoprotein-I, antiprothrombin (aPT) antibodies, F1 + 2, and lupus anticoagulants (LA) were measured in 25 thrombotic primary APS (PAPS), 9 nonthrombotic carriers of aPL, and 18 controls. The significant effect size (ES) for F1 + 2 between aPL +ve and aPL −ve systemic lupus erythematosus (SLE) and between aPL +ve SLE and control displayed high heterogeneity. The significant ES for F1 + 2 between aPL −ve SLE and controls displayed no heterogeneity. The ES for TAT between aPL +ve and aPL −ve SLE patients and between aPL −ve SLE and controls was low, without heterogeneity. Mean F1 + 2 was greater in PAPS ( p  < 0.0001), inversely correlated with IgG aCL, IgM aPT, and LA ( p  = 0.001, 0.03, and 0.01, respectively), though only IgG aCL negatively predicted F1 + 2 ( p  = 0.01). IgG aCL inversely predicts F1 + 2. IgG aCL positivity introduces heterogeneity in the F1 + 2 ES, whereas the lack of heterogeneity in the ES for TAT may indicate poor TAT formation in aPL +ve group. Thus, F1 + 2 measurements may be unfounded as already demonstrated for TAT in the 1990s. [ABSTRACT FROM AUTHOR]

The article presents case studies of two male elderly patients with acquired hemophilia A (AHA) and admitted to San Giuseppe Moscati Hospital's geriatric ward in Avellino, Italy during 2012- 2013 because of hematomas on their body. Topics discussed include an 89-year-old male patient taken to the emergency room and diagnosed with idiopathic AHA, and a 67-year-old man who was having past rheumatoid arthritis history and diagnosed with AHA autoimmune disorders related.

Copyright of Diversitas (17949998) is the property of Universidad Santo Tomas, Facultad de Psicologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. The prevalence of heart failure with preserved ejection fraction (HFpEF) in patients with antiphospholipid syndrome (APS) is unknown. Methods. A prospective multicenter cohort study including 125 patients was conducted: 91 primary APS (PAPS), 18 APS-SLE, and 16 carriers. HFpEF was diagnosed according to the 2019 European Society of Cardiology criteria: patients with ≥5 points among major and minor functional and morphological criteria including NT-ProBNP > 220 pg/mL, left atrial (LA) enlargement, increased left ventricular filling pressure. Results. Overall, 18 (14.4%) patients were diagnosed with HFpEF; this prevalence increased from 6.3% in carriers to 13.2% in PAPS and 27.8% in APS-SLE. Patients with HFpEF were older and with a higher prevalence of hypertension and previous arterial events. At logistic regression analysis, age, arterial hypertension, anticardiolipin antibodies IgG > 40 GPL (odds ratio (OR) 3.43, 95% confidence interval (CI) 1.09–10.77, p = 0.035), anti β-2-glycoprotein-I IgG > 40 GPL (OR 5.28, 1.53–18.27, p = 0.009), lupus anticoagulants DRVVT > 1.25 (OR 5.20, 95% CI 1.10–24.68, p = 0.038), and triple positivity (OR 3.56, 95% CI 1.11–11.47, p = 0.033) were associated with HFpEF after adjustment for age and sex. By multivariate analysis, hypertension (OR 19.49, 95% CI 2.21–171.94, p = 0.008), age (OR 1.07, 95% CI 1.00–1.14, p = 0.044), and aβ2GPI IgG > 40 GPL (OR 8.62, 95% CI 1.23–60.44, p = 0.030) were associated with HFpEF. Conclusion. HFpEF is detectable in a relevant proportion of APS patients. The role of aPL in the pathogenesis and prognosis of HFpEF needs further investigation. [ABSTRACT FROM AUTHOR]

This study analyzed the influence of sport on identity formation of 25 athletes through a semantic pattern and the life story characterization. Three groups characterized by the expression of their identity metamorphoses were identified. The first presented a form of instrumental rationality, linked to the victory, success and other characteristics of the spectacle sport. Two most autonomous groups united sports and non-sports experiences, reaching communicative rationality and multiplicity of roles in character manifestations. It was concluded that sport could enable emancipatory fragments depending on the multiplicity and richness of roles and environmental stimuli, favoring a plurality of experiences that instigate ecological transitions of autonomy. [ABSTRACT FROM AUTHOR]