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Objective: Deep vein thrombosis and pulmonary embolism referred as venous thromboembolism (VTE) are a common cause of morbidity and mortality. Plasma from healthy controls or individuals who have experienced a VTE were analyzed using metabolomics to characterize biomarkers and metabolic systems of patients with VTE. Approach and Results: Polar metabolite and lipidomic profiles from plasma collected 3 months after an incident VTE were obtained using liquid chromatography mass spectrometry. Fasting-state plasma samples from 42 patients with VTE and 42 healthy controls were measured. Plasma metabolomic profiling identified 512 metabolites forming 62 biological clusters. Multivariate analysis revealed a panel of 21 metabolites altogether capable of predicting VTE status with an area under the curve of 0.92 ( P =0.00174, selectivity=0.857, sensitivity=0.971). Multiblock systems analysis revealed 25 of the 62 functional biological groups as significantly affected in the VTE group ( P Conclusions: These findings show promise for the elucidation of underlying mechanisms and the design of a diagnostic test to assess the likely efficacy of clinical care in patients with VTE.

Chlormequat is a quaternary ammonium and choline chlorinated derivated is used as plant growth regulating agent. There are very few documented cases of poisoning in humans. We reported a case of non-fatal suicide attempt by chlormequat in France. A 34-year-old woman was admitted to hospital after deliberate consumption of plant growth regulator, C5 SUN, containing chlormequat chloride (460 g/L) and choline chloride (320 g/L). Immediately, she developed symptoms of respiratory distress and a cardiac massage was begun by her father. In this case report, we described the method for an accurate and reliable screening of chlormequat which was based on the combination of Target Analysis powerful software and a high performance TOF-MS (Impact HD from Bruker). After forced diuresis, the kinetic of elimination of chlormequat is biphasic: vascular phase diffusion (half-life of 5.6 hr) followed by a phase of free elimination (half-life of 16.2 h). Although chlormequat poisoning is clinically similar to that observed with anticholinesterase compounds, chlormequat chloride is not an acetylcholinesterase inhibitor. Chlormequat seems to be a weak substrat competitor for cholinesterase leading to acetylcholine accumulation and prolonged depolarization in muscular junction. Cardiac massage, artificial respiration and forced diuresis have significantly improved the prognosis of our patient.