Review
Biochemistry & Molecular Biology
Deepa J. Arachchillage, Mike Laffan, Charis Pericleous
Summary: Antiphospholipid syndrome (APS) is a highly prothrombotic disorder caused by thrombo-inflammatory antiphospholipid antibodies (aPL) that lead to thrombosis through various mechanisms. Obstetric complications in APS are a result of placental thrombosis, inflammation, and complement activation. While anticoagulation is the main treatment, it may not effectively prevent thrombosis recurrence in some patients, especially those with triple positive aPL.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Rheumatology
Juan J. Fierro, Manuela Velasquez-Berrio, Alexandra Ospina, Svenja Henning, Karina de Leeuw, J. Angela P. Cadavid
Summary: Hydroxychloroquine (HCQ) has been shown to have positive effects in patients with refractory obstetric APS, with its mechanisms of action including binding to sialic acid on cell membranes, blocking the binding of antiphospholipid antibodies to cells, and increasing extracellular and intracellular pH levels.
RHEUMATOLOGY INTERNATIONAL
(2023)
Article
Cell Biology
Jing Liu, Liting Zhang, Yijia Tian, Shuting Wan, Min Hu, Shasha Song, Meihua Zhang, Qian Zhou, Yu Xia, Xietong Wang
Summary: Obstetric antiphospholipid syndrome (OAPS) is a serious disease that threatens the health of pregnant women. Hydroxychloroquine (HCQ) has shown potential benefits in refractory OAPS, and its therapeutic mechanism involves reversing the effects of antiphospholipid antibodies on trophoblast cells, improving pregnancy outcomes, and reducing the incidence of pathological pregnancy.
JOURNAL OF CELLULAR AND MOLECULAR MEDICINE
(2022)
Review
Pharmacology & Pharmacy
Ariela Hoxha, Daniela Tormene, Elena Campello, Paolo Simioni
Summary: This study conducted a systematic review on the additional treatments used in refractory and high-risk antiphospholipid antibody syndrome (APS) pregnancies. The results showed that combination therapy with IVIG and PEX achieved a 100% live birth rate in refractory APS pregnancies, while Pravastatin, IA, and PEX showed higher live birth rates in high-risk APS pregnancies.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Pharmacology & Pharmacy
Stanley Niznik, Micha J. Rapoport, Orly Avnery, Aharon Lubetsky, Ronen Shavit, Martin H. Ellis, Nancy Agmon-Levin
Summary: Thrombotic events following diagnosis are common among female patients with primary antiphospholipid syndrome regardless of disease presentation. Heart valve disease and ANA positivity may be risk factors for thrombosis during follow-up of patients presenting with pure obstetric antiphospholipid syndrome.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Immunology
Xue Peng, Xi Tan, Aiyun Xing
Summary: Antiphospholipid syndrome (APS) is an acquired autoimmune disorder characterized by recurrent thrombosis and pregnancy complications. Obstetrical APS (OAPS) specifically refers to APS in pregnant women. The classification criteria for OAPS have generated discussion due to the possibility of excluding certain patients. This article presents two cases of non-criteria OAPS with severe complications and discusses the diagnosis, treatment, and prognosis of this unusual antenatal event. It also provides an overview of the pathogenetic mechanisms and clinical features of OAPS.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Hematology
Arne Vandevelde, Jean-Christophe Gris, Gary W. Moore, Jacek Musial, Stephane Zuily, Denis Wahl, Katrien M. J. Devreese
Summary: Currently, the added value of antiphosphatidylserine/prothrombin antibodies testing in the diagnosis of obstetric antiphospholipid syndrome seems limited compared with other antibodies. However, it may be useful in specific subsets of patients.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2023)
Article
Immunology
Arsenio Spinillo, Camilla Bellingeri, Irene De Maggio, Greta Riceputi, Maria Paola Pandolfi, Carolina Spada, Claudia Alpini, Carlomaurizio Montecucco, Fausta Beneventi
Summary: The study found that patients with APS are more likely to have a high-risk aPL profile and a higher rate of adverse pregnancy outcomes, while CTDs are associated with an increased risk of adverse obstetric outcomes. Low-risk antibody carriers are more likely to contribute to adverse obstetric events compared to high-risk patients, and single positivity is associated with a higher burden of obstetric complications compared to double/triple positivity.
JOURNAL OF REPRODUCTIVE IMMUNOLOGY
(2021)
Review
Endocrinology & Metabolism
Shenghan Xu, Miao Liu, Jiamu Xu, Bangwei Che, Wenjun Zhang, Wei Li, Tao Huang, Ying Yu, Cheng Zha, Zheng Peng, Kunyuan Huang, Kaifa Tang
Summary: This case report shares the management experience of a patient with pregnancy combined with adrenal adenoma causing ACTH-independent Cushing's syndrome (CS), accompanied by obstetric antiphospholipid syndrome (OAPS) and severe pre-eclampsia. The patient underwent laparoscopic adrenal tumor resection under general anesthesia at 23 weeks of gestation and cesarean section at 39 weeks to give birth to a healthy baby girl with an Apgar score of 10. Pregnancy complicated by CS is rare and difficult to diagnose, but diagnostic methods such as 24-hour urinary free cortisol, cortisol circadian rhythm, ultrasound, and MRI can be helpful. Furthermore, this case highlights the importance of recognizing and treating OAPS in patients with CS during pregnancy.
FRONTIERS IN ENDOCRINOLOGY
(2023)
Review
Immunology
Allyssa Hooper, Vanessa Bacal, Mohamed A. Bedaiwy
Summary: The use of hydroxychloroquine (HCQ) in addition to aspirin and heparin can reduce the risk of obstetric complications caused by antiphospholipid antibody syndrome (APS) and improve live birth rate while decreasing pregnancy loss rate.
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
(2023)
Article
Rheumatology
Leyre Riancho-Zarrabeitia, Laura Lopez-Marin, Pedro Munoz Cacho, Marcos Lopez-Hoyos, Rafael del Barrio, Ana Haya, Victor M. Martinez-Taboada
Summary: This study retrospectively described a group of refractory oAPS patients treated with low-dose glucocorticoids and conducted a meta-analysis, finding that glucocorticoids can increase the rate of successful pregnancy, but high-dose steroids can increase the rate of maternal and fetal morbidities.
Review
Immunology
Chieko Mineo, Philip W. Shaul, Bonnie L. Bermas
Summary: Antiphospholipid syndrome is an autoimmune disease characterized by the presence of antibodies against phospholipids, which leads to thrombosis and pregnancy-related complications. Recent research has focused on discovering novel mechanisms underlying obstetric APS.
CLINICAL IMMUNOLOGY
(2023)
Article
Hematology
Leslie Skeith, Marc A. Rodger, Shannon M. Bates, Carol Gonsalves, Alan Karovitch, Taryn S. Taylor
Summary: The study investigated how patients and physicians navigate decision-making process for using LMWH and/or ASA during pregnancy. Three themes were identified: managing high stakes, accepting uncertainty, and focusing on safety. Patients took action to avoid further pregnancy loss, while physicians tended to leave the decision up to the patient. These findings should be considered when designing future research on the role of LMWH/ASA in this population.
THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Obstetrics & Gynecology
Jamilya Khizroeva, Victoria Bitsadze, Angela Tincani, Alexander Makatsariya, Madina Arslanbekova, Nigar Babaeva, Valentina Tsibizova, Andrei Shkoda, Natalya Makatsariya, Maria Tretyakova, Antonina Solopova, Zumrad Gadaeva, Alexander Vorobev, Inessa Khamani, Zamilya Aslanova, Inga Nakaidze, Alexander Mischenko, Kristina Grigoreva, Nart Kunesko, Elena Egorova, Tamara Mashkova
Summary: The traditional treatment protocol of obstetric antiphospholipid syndrome may not always be effective for all patients, suggesting the potential need for alternative therapies to improve obstetric outcomes. Hydroxychloroquine (HCQ) shows promise as an additional therapy to conventional anticoagulant treatment for patients with refractory obstetric antiphospholipid syndrome.
JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE
(2022)
Article
Immunology
Jiapo Li, Yue Hou, Liyang Zhang, Fan Li, Qian Liu, Yuanyuan Li, Hongfei Shen, Ziyue Xiong, Ling Huang, Chong Qiao
Summary: This study found clinical and laboratory differences between patients with obstetric antiphospholipid syndrome (OAPS) and non-criteria obstetric antiphospholipid syndrome (NC-OAPS). Patients in different subgroups of NC-OAPS could be identified with different clinical phenotypes. The OAPS group showed a relatively hypercoagulable state compared to the NC-OAPS group, especially in the subgroup that met the clinical criteria. There were no significant differences in treatment strategy or pregnancy outcomes between the two groups.
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
(2023)
Article
Gastroenterology & Hepatology
Manuel Mendizabal, Marcelo Dip, Ezequiel Demirdjian, Leandro Lauferman, Susana Lopez, Julia Minetto, Alejandro Costaguta, Carolina Rumbo, Ivone Malla, Maria Camila Sanchez, Esteban Halac, Guillermo Cervio, Miriam Cuarterolo, Marcela Galoppo, Oscar Imventarza, Liliana Bisgniano, Daniel D'Agostino, Fernando Rubinstein
LIVER TRANSPLANTATION
(2020)
Article
Gastroenterology & Hepatology
Manuel Mendizabal, Pablo Testa, Mercedes Rojas, Carla S. Colaci, Solana Elias, Paula Nicolini, Soledad Olguin, Carolina Dunn, Claudio Ronchi, Mariano Barreiro, Mercedes Zirpoli, Federico Pinero, Sanjeev Arora, Martin O'Flaherty, Fernando Rubinstein, Marcelo O. Silva
JOURNAL OF VIRAL HEPATITIS
(2020)
Article
Surgery
Federico Pinero, Margarita Anders, Ilka F. Boin, Aline Chagas, Emilio Quinonez, Sebastian Marciano, Mario Vilatoba, Luisa Santos, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaria Menendez, Martin Padilla, Jaime Poniachik, Rodrigo Zapata, Alejandro Soza, Martin Maraschio, Ricardo Chong Menendez, Linda Munoz, Diego Arufe, Rodrigo Figueroa, Elaine Cristina de Ataide, Claudia Maccali, Rodrigo Vergara Sandoval, Carla Bermudez, Luis G. Podesta, Lucas McCormack, Adriana Varon, Adrian Gadano, Juan Mattera, Federico Villamil, Fernando Rubinstein, Flair Carrilho, Marcelo Silva
Summary: This study compared liver transplantation outcomes for hepatocellular carcinoma under different allocation policies, finding that some policies may help reduce recurrence rates or increase the number of HCC patients eligible for transplantation. However, overly strict policies could raise ethical concerns regarding organ allocation.
TRANSPLANT INTERNATIONAL
(2021)
Article
Gastroenterology & Hepatology
Manuel Mendizabal, Federico Pinero, Ezequiel Ridruejo, Margarita Anders, Maria Dolores Silveyra, Aldo Torre, Pedro Montes, Alvaro Urzua, Josefina Pages, Luis G. Toro, Javier Diaz, Esteban Gonzalez Ballerga, Godolfino Miranda-Zazueta, Mirta Peralta, Isabel Gutierrez, Douglas Michelato, Maria Grazia Venturelli, Adriana Varon, Emilia Vera-Pozo, Martin Tagle, Matias Garcia, Alfredo Tassara, Julia Brutti, Sandro Ruiz Garcia, Carla Bustios, Nataly Escajadillo, Yuridia Macias, Fatima Higuera-de la Tijera, Andres J. Gomez, Alejandra Dominguez, Mauricio Castillo-Barradas, Fernando Contreras, Aldana Scarpin, Maria Isabel Schinoni, Claudio Toledo, Marcos Girala, Victoria Mainardi, Abel Sanchez, Fernando Bessone, Fernando Rubinstein, Marcelo O. Silva
Summary: This prospective cohort study involving 1611 hospitalized patients from 11 Latin American countries found that abnormal liver tests on admission were independently associated with mortality and severe COVID-19 in patients with COVID-19 infection.
ANNALS OF HEPATOLOGY
(2021)
Article
Health Care Sciences & Services
Sarah Iribarren, Hannah Milligan, Kyle Goodwin, Omar Alfonso Aguilar Vidrio, Cristina Chirico, Hugo Telles, Daniela Morelli, Barry Lutz, Jennifer Sprecher, Fernando Rubinstein
Summary: This study aims to evaluate the effectiveness of a TB treatment support tool intervention on treatment outcomes and assess patient and provider perceptions of the facilitators and barriers to implementation. The intervention includes a smartphone app, treatment supporter, and a home-based adherence test strip, with the hypothesis that it will be more effective in improving outcomes. Data collection is expected to be completed by 2022, with results to be published within a year, providing evidence on the adoption of mobile health tools and broader implications for chronic disease management.
JMIR RESEARCH PROTOCOLS
(2021)
Article
Gastroenterology & Hepatology
Manuel Mendizabal, Ezequiel Ridruejo, Federico Pinero, Margarita Anders, Martin Padilla, Luis G. Toro, Aldo Torre, Pedro Montes, Alvaro Urzua, Esteban Gonzalez Ballerga, Maria Dolores Silveyra, Douglas Michelato, Javier Diaz, Mirta Peralta, Josefina Pages, Sandro Ruiz Garcia, Isabel Gutierrez Lozano, Yuridia Macias, Daniel Cocozzella, Norberto Chavez-Tapia, Martin Tagle, Alejandra Dominguez, Adriana Varon, Emilia Vera Pozo, Fatima Higuera-de la Tijera, Carla Bustios, Damian Conte, Nataly Escajadillo, Andres J. Gomez, Laura Tenorio, Mauricio Castillo Barradas, Maria Isabel Schinoni, Fernando Bessone, Fernando Contreras, Leyla Nazal, Abel Sanchez, Matias Garcia, Julia Brutti, Maria Cecilia Cabrera, Godolfino Miranda-Zazueta, German Rojas, Maximo Cattaneo, Graciela Castro-Narro, Fernando Rubinstein, Marcelo O. Silva
Summary: The study found that SARS-CoV-2 infection increases mortality rate in patients with cirrhosis, with cirrhotic patients having a higher mortality rate compared to non-cirrhotic patients. In predicting mortality in cirrhotic patients, the CLIF-C scoring system performed better than NACSELD, CTP, and MELD-Na.
ANNALS OF HEPATOLOGY
(2021)
Article
Health Care Sciences & Services
Fernando Rubinstein, Alejandro Blumenfeld
Summary: Tuberculosis remains a major public health problem in many regions worldwide. Comprehensive and inclusive responses that address structural determinants such as poverty, nutrition, sanitation, housing, and access to healthcare, along with timely diagnosis and support during treatment, are crucial for tuberculosis control.
INTERNATIONAL JOURNAL OF HEALTH POLICY AND MANAGEMENT
(2023)
Article
Health Care Sciences & Services
Sarah J. Iribarren, Hannah Milligan, Cristina Chirico, Kyle Goodwin, Rebecca Schnall, Hugo Telles, Alejandra Iannizzotto, Myrian Sanjurjo, Barry R. Lutz, Kenneth Pike, Fernando Rubinstein, Marcus Rhodehamel, Daniel Leon, Jesse Keyes, George Demiris
Summary: This study explored the acceptability, feasibility, and refinement needs of a TB Treatment Support Tools intervention. The results showed that the intervention was feasible and acceptable, and further improvements and testing are necessary.
LANCET REGIONAL HEALTH-AMERICAS
(2022)
Article
Gastroenterology & Hepatology
Charlotte Costentin, Federico Pinero, Helena Degroote, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Luis G. Podesta, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrizio Dibenedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Sebastian Marciano, Claire Vanlemmens, Stefano Fagiuoli, Patrizia Burra, Hans Van Vlierberghe, Daniel Cherqui, Quirino Lai, Marcelo Silva, Fernando Rubinstein, Christophe Duvoux
Summary: Reassessing the risk of recurrence after liver transplantation (LT) is critical for optimizing the management of patients with hepatocellular carcinoma (HCC). In this study, a new model called R3-AFP was designed and validated based on variables associated with recurrence post-LT, providing a robust framework for designing post-LT surveillance strategies, protocols, or adjuvant therapy trials for HCC patients. The R3-AFP model outperformed the original R3 model, which was solely based on explant features.
Letter
Surgery
Federico Pinero, Fernando Rubinstein, Alexis Laurent, Marcelo Silva, Daniel Cherqui, Christophe Duvoux
Article
Gastroenterology & Hepatology
Helena Degroote, Federico Pinero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrian Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux
Summary: Successful downstaging of more advanced hepatocellular carcinoma (HCC) within the UCSF-DS protocol to the conventional Milan criteria does not result in a higher recurrence rate after liver transplantation (LT) compared to patients remaining within Milan criteria. Additionally, in the UCSF-DS group, an ALP value equal to or below 20 ng/ml at listing might be a novel tool to further optimize selection of candidates for LT.
Article
Hematology
E. O. Artemenko, S. I. Obydennyi, K. S. Troyanova, G. A. Novichkova, D. Y. Nechipurenko, M. A. Panteleev
Summary: In this study, we investigated the adhesive properties of circulating plasma-derived and platelet-derived microvesicles (MVs) and their potential role in thrombus growth. The results showed that both types of MVs weakly bound fibrinogen but did not stably adhere to immobilized fibrinogen. Moreover, the presence of these MVs did not significantly affect thrombus formation. Therefore, MVs present in the plasma of healthy individuals are unlikely to directly contribute to thrombus formation under arterial flow conditions.
THROMBOSIS RESEARCH
(2024)
Letter
Hematology
Giuseppe Lippi, Camilla Mattiuzzi, Emmanuel J. Favaloro
THROMBOSIS RESEARCH
(2024)
Article
Hematology
Marium Malik, Maha Al-Ghafry, Abraham Haimed, Julia Su, Maribel Lema, Linda Shore-Lessersson, Suchitra S. Acharya
Summary: This study analyzed and evaluated leukemia-associated coagulopathy in newly diagnosed pediatric leukemia patients using CCTs and ROTEM. The results showed that fibrinogen and platelets played a significant role in causing coagulopathies in this population. This suggests the utility of using CCTs and ROTEM in the pediatric population to evaluate hemostatic function and guide blood product replacement.
THROMBOSIS RESEARCH
(2024)
Review
Hematology
Mohammad M. Elahi, Alexandra N. Witt, Edward L. G. Pryzdial, Paul B. McBeth
Summary: Thrombotic disease may be underdiagnosed in microgravity conditions, and the underlying factors are still poorly understood. A case of internal jugular vein thrombosis was recently diagnosed in a low-risk female astronaut, and six out of ten additional crew members showed risk factors for jugular venous flow. Observations in space and studies on Earth suggest that microgravity affects blood flow, coagulation, and vascular function.
THROMBOSIS RESEARCH
(2024)
Review
Hematology
Stian Ingemann-Molden, Christina Krogner Caspersen, Nanna Rolving, Anette Arbjerg Hojen, Frederikus A. Klok, Erik L. Grove, Barbara Cristina Brocki, Jane Andreasen
Summary: This study found that no single PROM covered all aspects considered important by PE patients. PROMs recommended in the ICHOM core set covered most aspects, but worrisome thoughts, hypervigilance around symptoms, and uncertainty of illness were not covered.
THROMBOSIS RESEARCH
(2024)
Article
Hematology
Haomin Yan, Tsutomu Sasaki, Yasufumi Gon, Kumiko Nishiyama, Hideaki Kanki, Hideki Mochizuki
Summary: The incidence of cancer-associated stroke has increased with the prolonged survival times of cancer patients. In this study, the researchers focused on the driver gene KRAS and found that KRAS mutations exacerbated neurological deficits after stroke and promoted tumor growth. They also identified the upregulation of pro-inflammatory responses and the promotion of STAT3 phosphorylation in mice with KRAS mutations. Additionally, the researchers found that colorectal cancer patients with stroke onset within 3 months after cancer diagnosis had a worse prognosis.
THROMBOSIS RESEARCH
(2024)
Letter
Hematology
Tomoki Togashi, Satomi Nagaya, Makiko Meguro-Horike, Haruto Matsumoto, Yuta Imai, Koichi Yamaguchi, Yoshinari Fujii, Haruka Moriya, Yuika Kikuchi, Ibuki Yasuda, Shin-ichi Horike, Eriko Morishita
THROMBOSIS RESEARCH
(2024)
Article
Hematology
Marta Najarro, Winnifer Briceno, Carmen Rodriguez, Alfonso Muriel, Sara Gonzalez, Ana Castillo, Ignacio Jara, Parth Rali, Catalin Toma, Behnood Bikdeli, David Jimenez
Summary: The CPES score is a useful tool in identifying the risk of hemodynamic deterioration in normotensive patients with acute PE, with acceptable C-statistic, excellent specificity, and low positive predictive value.
THROMBOSIS RESEARCH
(2024)
Article
Hematology
Lei Liu, Huifang Xu, Jian Wang, Haiyan Wang, Saisai Ren, Qian Huang, Mingyan Zhang, Hui Zhou, Chunyan Yang, Lu Jia, Yu Huang, Hao Zhang, Yanling Tao, Ying Li, Yanan Min
Summary: This study investigated the gut microbiota metabolites and cytokines, chemokines, and growth factors in patients with ITP and found their association with treatment responsiveness. The findings suggest that imbalanced secretion of cyto(chemo)kins/growth factors and inadequate levels of TMAO are characteristic of patients with ITP.
THROMBOSIS RESEARCH
(2024)
Article
Hematology
Roxanne Mcknight, Mohammad Salameh, Lee Ann Jones, Greta Anton, Lindsay Carter
Summary: This study evaluated the safety of fixed-dose heparin titration boluses in underweight patients with VTE. The results showed that although underweight patients required more frequent holding of heparin, there was no significant increase in bleeding risk.
THROMBOSIS RESEARCH
(2024)
