ADAMTS-13 and von Willebrand factor predict venous thromboembolism in patients with cancer.

UNLABELLED: ESSENTIALS: Cancer patients are at high risk of venous thromboembolism (VTE). In this study, cases and controls were cancer patients who did or did not develop VTE. von Willebrand factor (VWF) levels were higher if compared with controls and correlated with cancer stage. VWF and ADAMTS-13 are associated with the occurrence of VTE in cancer. BACKGROUND: Patients with cancer are at high risk of venous thromboembolism (VTE). ADAMTS-13 regulates von Willebrand factor (VWF) activity, which plays a role in the development of cancer and in VTE. OBJECTIVES: The aim of this study was to search for an association between the levels of VWF and ADAMTS-13 and VTE in patients with cancer and to compare current scoring systems for prediction of VTE before and after addition of these parameters. PATIENTS/METHODS: In a case-control study, in which patients with recently diagnosed cancer were followed-up for 6 months, we compared 20 patients who developed VTE (cases) and 140 patients with cancer without VTE (controls), matched for sex, age, and type and stage of cancer. We measured VWF, ADAMTS-13 (activity and antigen), P-selectin, D-dimer and F1 + 2 levels at baseline, and calculated both the Khorana score and the Khorana score expanded after addition of P-selectin and D-dimer levels. RESULTS: VWF levels were significantly higher in cases when compared with controls (326 ± 185% vs. 242 ± 158%) and correlated with advanced stage of cancer: localized, 185 [142; 222]; locally advanced, 240 [146; 257]; metastatic, 267 [153; 324] (mean [interquartile range]). The addition of two biomarkers, ADAMTS-13 activity and F1 + 2 levels, to the Khorana score improved receiver operating curves. CONCLUSIONS: von Willebrand factor and ADAMTS-13 are associated with the occurrence of VTE in patients with cancer. Moreover, addition of ADAMTS-13 and F1 + 2 levels to the Khorana score considerably increases the predictive value for VTE.

The risk of small ruminant lentivirus (SRLV) transmission with reproductive biotechnologies: state-of-the-art review.

Reproductive biotechnologies are essential to improve the gene pool in small ruminants. Although embryo transfer (ET) and artificial insemination (AI) greatly reduce the risk of pathogen transmission, few studies have been performed to quantify this risk. The aim of this review is to contribute to the elements needed to evaluate the risk of lentivirus transmission in small ruminants (SRLV) during ET, from embryos produced in vitro or in vivo, and with the use of the semen destined for AI. The purpose is to consider the genetic possibilities of producing uninfected embryos from infected females and males or bearers of the SRLV genome. We have reviewed various studies that evaluate the risk of SRLV transmission through genital tissues, fluids, cells, and flushing media from female and male animals. We have only included studies that apply the recommendations of the International Embryo Transfer Society, to obtain SRLV-free offspring from infected female animals using ET, and the justification for using healthy male animals, free from lentivirus, as semen donors for AI. As such, ET and AI will be used as routine reproductive techniques, with the application of the recommendations of the International Embryo Transfer Society and World Organization for Animal Health.

Studies of collagen synthesis and structure in the differentiation of child abuse from osteogenesis imperfecta.

OBJECTIVE: To determine whether analysis of collagen synthesized by dermal fibroblasts could identify children with osteogenesis imperfecta (OI) among those suspected to have been abused. METHODS: We reviewed biochemical studies and clinical findings for all children who were referred to us to distinguish OI from abuse during a 4-year period. RESULTS: Cells from 6 of 48 children tested to distinguish OI from abuse had biochemical evidence of OI. In five of the six children with abnormal results on collagen studies, clinical signs of OI in addition to fractures were present on examination by a physician familiar with the condition. In those five cases, the diagnosis of OI was strongly suspected. CONCLUSIONS: OI can be diagnosed by biochemical studies in some cases of suspected abuse, but clinical evaluation by experienced physicians is usually sufficient to do so. When diagnostic uncertainty persists in cases of suspected child abuse, biochemical studies may be a useful adjunct, but routine biopsy for children suspected to have been abused is unwarranted.

Reevaluation of Russell-Silver syndrome.

Russell-Silver syndrome was reevaluated 2.9 to 13.0 years after initial diagnosis in 15 patients. At follow-up, five of the 15 patients exhibited late catch-up growth and had normal height, six had developmental delays or mental retardation, and asymmetry was present in five. Given the great variability in the long-term prognosis for growth and development in patients with Russell-Silver syndrome, there is a need to reevaluate this syndrome and its clinical implications.