scholarly journals Έλεγχος με οπτική θολοσιμετρική συσσώρευση και multiplate της αιμοπεταλιακής απάντησης στην κλοπιδογρέλη στεφανιαίων ασθενών με σακχαρώδη διαβήτη τύπου ΙΙ υπό διπλή κλασική αντιαιμοπεταλιακή αγωγή και συσχέτιση του εργαστηριακού ευρήματος με την κλινική έκβαση

2020 ◽  
Author(s):  
Μαρία Τάιχερτ
Keyword(s):  
Odds Ratio ◽  
Light Transmission ◽  
Cohen’S Kappa ◽  
Multiple Electrode Aggregometry ◽  
Cohen's Kappa ◽  
Light Transmission Aggregometry ◽  
Multiple Electrode

Στόχος: Περιορισμένα ήταν τα διαθέσιμα δεδομένα σχετικά με την κλινική σημασία των μετρήσεων της λειτουργικότητας των αιμοπεταλίων σε σταθερούς ασθενείς με στεφανιαία νόσο (ΣΝ). Στόχος μας είναι να αξιολογήσουμε τη συμφωνία μεταξύ της Συσσωματομετρίας Σύνθετης Αντίστασης (Multiple Electrode Aggregometry, MEA και της Οπτικής Θολοσιμετρικής Συσσώρευσης (Light Transmission Aggregometry, LTA) στην ανίχνευση των ασθενών με χαμηλή απόκριση στην κλοπιδογρέλη και την προγνωστική τους αξία σε ασθενείς με ΣΝ και με σακχαρώδη διαβήτη τύπου 2 (ΣΔτ2) υπό διπλή αναστολή αιμοπεταλίων. Μέθοδοι: Η LTA και η ΜΕΑ πραγματοποιήθηκαν σε 122 σταθερούς καρδιαγγειακούς ασθενείς με ΣΔτ2. Ασθενείς με μετρήσεις LTAmax και MEA στο ανώτερο τεταρτημόριο ορίστηκαν ως χαμηλής απόκρισης στην κλοπιδογρέλη. Η συμφωνία μεταξύ των δύο μεθόδων αξιολογήθηκε με στατιστικά στοιχεία kappa. Εκτιμήσαμε την πιθανή συσχέτιση μεταξύ της ανταπόκρισης στην αντιαιμοπεταλιακή θεραπεία και την κλινική έκβαση. Επίσης, εκτιμήσαμε το βέλτιστο διαγνωστικό όριο σύμφωνα με την ανάλυση ROC για την πρόβλεψη της εμφάνισης αθηροθρομβωτικών επιπλοκών κατά τη διάρκεια της 1 έτους περιόδου παρακολούθησης. Αποτελέσματα: Οι συντελεστές Cohen’s kappa (0,214) έδειξαν μέτρια συμφωνία (70,2%) μεταξύ LTA και MEA. Συνολικά 25 MACE εμφανίστηκαν σε 108 ασθενείς (23,1%). Οι ασθενείς με MACE είχαν υψηλότερο LTAmax από αυτούς χωρίς (57,1 ± 16,5 έναντι 49,3 ± 18,3, αντίστοιχα, p = 0,023). Οι μετρήσεις ΜΕΑ ήταν παρόμοιες μεταξύ των ασθενών με και χωρίς MACE (30,1 ± 15,4 έναντι 30,6 ± 20,8, αντίστοιχα, p = 0,84). Η πολλαπλή λογιστική παλινδρόμηση έδειξε ότι οι μετρήσεις LTAmax αποτελούν ανεξάρτητο προγνωστικό παράγοντα θανάτου από καρδιαγγειακά αίτια (Odds Ratio, προσαρμοσμένες: 0,2, 0,05-0,81). Η ανάλυση ROC έδειξε ότι μια μέγιστη τιμή συσσωμάτωσης περίπου 62,5% φαίνεται να αποτελεί μια κρίσιμη μεταβλητή της κλινικής πρόγνωσης σε ασθενείς με ΣΔτ2 και ΣΝ (AUC = 0,67, ευαισθησία = 78%, εξειδίκευση = 61,5%). Συμπεράσματα: Η εκτίμηση της απόκρισης των αιμοπεταλίων παραμένει ιδιαίτερα εξειδικευμένη, με ανεπαρκή συμφωνία μεταξύ των δοκιμών. Τα αποτελέσματά μας υποστηρίζουν την εφαρμογή της LTA, αλλά όχι της MEA για την αξιολόγηση κινδύνου εμφάνισης MACE σε σταθερούς καρδιαγγειακούς ασθενείς με ΣΔτ2.

Assessment of ADP-induced platelet aggregation with light transmission aggregometry and multiple electrode platelet aggregometry before and after clopidogrel treatment

2008 ◽  
Vol 99 (01) ◽  
pp. 121-126 ◽  
Author(s):  
Siegmund Braun ◽  
Stefan Jawansky ◽  
Wolfgang Vogt ◽  
Julinda Mehilli ◽  
Albert Schömig ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Platelet Function ◽  
Whole Blood ◽  
Light Transmission ◽  
Platelet Rich Plasma ◽  
Platelet Aggregometry ◽  
Light Transmission Aggregometry ◽  
Before And After ◽  
Standardized Method ◽  
Multiple Electrode

SummaryThe level of platelet aggregation, measured with light transmission aggregometry (LTA) in platelet rich plasma (PRP), has been shown to predict outcomes after percutaneous coronary intervention (PCI). However, measuring parameters of platelet function with LTA is time consuming and weakly standardized. Thus, a fast and standardized method to assess platelet function after clopidogrel treatment would be of great value for clinical practice. A new method, multiple electrode platelet aggregometry (MEA), to rapidly measure platelet aggregation in whole blood has recently been developed. The aim of this study was to assess parameters of platelet function with MEA and LTA before and after administration of 600 mg clopidogrel. Blood samples from 149 patients scheduled for coronary angiography were taken after clopidogrel treatment; in addition, in 60 of the patients samples were available before clopidogrel treatment. ADP-induced platelet aggregation was measured with LTA and simultaneously in whole blood with MEA on the Multiplate analyzer. Platelet aggregation measured with MEA decreased significantly after clopidogrel treatment (P<0.0001). ADP-induced platelet aggregation assessed with MEA and LTA correlated significantly (Spearman rank correlation coefficient=0.71; P<0.0001).The results of MEA, a fast and standardized method to assess the platelet response to ADP prior to and after clopidogrel treatment, correlate well with LTA.

Comparison of platelet aggregation using light transmission and multiple electrode aggregometry in Glanzmann thrombasthenia

Platelets ◽  
2009 ◽  
Vol 20 (5) ◽  
pp. 297-301 ◽  
Author(s):  
Abdalla Awidi ◽  
Ahmad Maqablah ◽  
Manar Dweik ◽  
Nazzal Bsoul ◽  
Ahmad Abu-Khader
Keyword(s):  
Platelet Aggregation ◽  
Light Transmission ◽  
Glanzmann Thrombasthenia ◽  
Multiple Electrode Aggregometry ◽  
Multiple Electrode

scholarly journals Comparison of Light Transmission Aggregometry With Impedance Aggregometry in Patients on Potent P2Y12 Inhibitors

2020 ◽  
pp. 107424842096870
Author(s):  
Patricia P. Wadowski ◽  
Joseph Pultar ◽  
Constantin Weikert ◽  
Beate Eichelberger ◽  
Irene M. Lang ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Light Transmission ◽  
Platelet Reactivity ◽  
Adenosine Diphosphate ◽  
P2y12 Inhibitors ◽  
Coronary Syndrome ◽  
Multiple Electrode Aggregometry ◽  
Impedance Aggregometry ◽  
Light Transmission Aggregometry ◽  
Sensitivity Specificity

Since data on the agreement between light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA) in patients on the more potent P2Y12 inhibitors are missing so far, we investigated if the evaluation of the responsiveness to therapy by LTA can be replaced by MEA in 160 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel or ticagrelor (n = 80 each). Cut-off values for high on-treatment residual platelet reactivity (HRPR) in response to adenosine diphosphate (ADP) or arachidonic acid (AA) were defined according to previous studies showing an association of HRPR with the occurrence of adverse ischemic outcomes. ADP- inducible platelet aggregation was 33% and 37% (p = 0.07) by LTA and 19 AU and 20 AU (p = 0.38) by MEA in prasugrel- and ticagrelor-treated patients, respectively. AA- inducible platelet aggregation was 2% and 3% by LTA and 15 AU and 16 AU by MEA, (all p ≥ 0.3) in patients on prasugrel and ticagrelor, respectively. By LTA, HRPR ADP and HRPR AA were seen in 5%/5% and in 4%/ 13% of patients receiving prasugrel- and ticagrelor, respectively. By MEA, HRPR ADP and HRPR AA were seen in 3%/ 25% and 0%/24% of prasugrel- and ticagrelor-treated patients, respectively. ADP-inducible platelet reactivity by MEA correlated significantly with LTA ADP in prasugrel-treated patients (r = 0.4, p < 0.001), but not in those receiving ticagrelor (r = 0.09, p = 0.45). AA-inducible platelet aggregation by LTA and MEA did not correlate in prasugrel- and ticagrelor-treated patients. Sensitivity/specificity of HRPR by MEA to detect HRPR by LTA were 25%/99% for MEA ADP and 100%/79% for MEA AA in prasugrel-treated patients, and 0%/100% for MEA ADP and 70%/83% for MEA AA in ticagrelor-treated patients. In conclusion, on-treatment residual ADP-inducible platelet reactivity by LTA and MEA shows a significant correlation in prasugrel- but not ticagrelor-treated patients. However, in both groups LTA and MEA revealed heterogeneous results regarding the classification of patients as responders or non-responders to P2Y12 inhibition.

Inter-individual variability in clopidogrel inhibition effect on platelet aggregation

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Hussein Ali Sahib ◽  
Bassim Irhiem Mohammed ◽  
Ban A. Abdul Majid
Keyword(s):  
Cardiovascular Disease ◽  
Platelet Aggregation ◽  
Coronary Care Unit ◽  
Light Transmission ◽  
Individual Variability ◽  
Study Group ◽  
Inhibition Effect ◽  
Light Transmission Aggregometry ◽  
Coronary Care ◽  
Skewness And Kurtosis

Despite the unmistakable beneficial effect of clopidogrel on platelet aggregation,still there are some patient poorly responds to clopidogrel that may lead to worse cardiovascular clinical events.One hundred and twenty seven patients with cardiovascular disease (ACS,stroke,or TIA) were enrolled as a study group. Patients were recruited at coronary care unit (CCU) of Al-Yarmouk Teaching Hospital. Paletlet assessment was done by using light transmission aggregometry. between the patients that enrolled in this study there are significant inter-individual variability both skewness and Kurtosis were negative (-0.450,-0.130) respectively. 24% of patient enrolled in this study were hyporesponder.

scholarly journals An update on image forming methods: structure analysis and Gestalt evaluation of images from rocket lettuce with shading, N supply, organic or mineral fertilization, and biodynamic preparations

2021 ◽  
Author(s):  
Miriam Athmann ◽  
Roya Bornhütter ◽  
Nicolaas Busscher ◽  
Paul Doesburg ◽  
Uwe Geier ◽  
...  
Keyword(s):  
Copper Chloride ◽  
Organic Fertilizer ◽  
Structural Features ◽  
Fertilizer Treatment ◽  
Friedman Test ◽  
Mineral Fertilization ◽  
Cohen’S Kappa ◽  
N Supply ◽  
Cohen's Kappa ◽  
Forming Methods

AbstractIn the image forming methods, copper chloride crystallization (CCCryst), capillary dynamolysis (CapDyn), and circular chromatography (CChrom), characteristic patterns emerge in response to different food extracts. These patterns reflect the resistance to decomposition as an aspect of resilience and are therefore used in product quality assessment complementary to chemical analyses. In the presented study, rocket lettuce from a field trial with different radiation intensities, nitrogen supply, biodynamic, organic and mineral fertilization, and with or without horn silica application was investigated with all three image forming methods. The main objective was to compare two different evaluation approaches, differing in the type of image forming method leading the evaluation, the amount of factors analyzed, and the deployed perceptual strategy: Firstly, image evaluation of samples from all four experimental factors simultaneously by two individual evaluators was based mainly on analyzing structural features in CapDyn (analytical perception). Secondly, a panel of eight evaluators applied a Gestalt evaluation imbued with a kinesthetic engagement of CCCryst patterns from either fertilization treatments or horn silica treatments, followed by a confirmatory analysis of individual structural features. With the analytical approach, samples from different radiation intensities and N supply levels were identified correctly in two out of two sample sets with groups of five samples per treatment each (Cohen’s kappa, p = 0.0079), and the two organic fertilizer treatments were differentiated from the mineral fertilizer treatment in eight out of eight sample sets with groups of three manure and two minerally fertilized samples each (Cohen’s kappa, p = 0.0048). With the panel approach based on Gestalt evaluation, biodynamic fertilization was differentiated from organic and mineral fertilization in two out of two exams with 16 comparisons each (Friedman test, p < 0.001), and samples with horn silica application were successfully identified in two out of two exams with 32 comparisons each (Friedman test, p < 0.001). Further research will show which properties of the food decisive for resistance to decomposition are reflected by analytical and Gestalt criteria, respectively, in CCCryst and CapDyn images.

scholarly journals Prediction of Streptococcus uberis clinical mastitis treatment success in dairy herds by means of mass spectrometry and machine-learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexandre Maciel-Guerra ◽  
Necati Esener ◽  
Katharina Giebel ◽  
Daniel Lea ◽  
Martin J. Green ◽  
...  
Keyword(s):  
Machine Learning ◽  
Mass Spectrometry ◽  
Treatment Success ◽  
Clinical Mastitis ◽  
Supervised Machine Learning ◽  
Structural Protein ◽  
Cohen’S Kappa ◽  
Maldi Tof ◽  
Streptococcus Uberis ◽  
Cohen's Kappa

AbstractStreptococcus uberis is one of the leading pathogens causing mastitis worldwide. Identification of S. uberis strains that fail to respond to treatment with antibiotics is essential for better decision making and treatment selection. We demonstrate that the combination of supervised machine learning and matrix-assisted laser desorption ionization/time of flight (MALDI-TOF) mass spectrometry can discriminate strains of S. uberis causing clinical mastitis that are likely to be responsive or unresponsive to treatment. Diagnostics prediction systems trained on 90 individuals from 26 different farms achieved up to 86.2% and 71.5% in terms of accuracy and Cohen’s kappa. The performance was further increased by adding metadata (parity, somatic cell count of previous lactation and count of positive mastitis cases) to encoded MALDI-TOF spectra, which increased accuracy and Cohen’s kappa to 92.2% and 84.1% respectively. A computational framework integrating protein–protein networks and structural protein information to the machine learning results unveiled the molecular determinants underlying the responsive and unresponsive phenotypes.

scholarly journals The accuracy of initial diagnoses in coma: an observational study in 835 patients with non-traumatic disorder of consciousness

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Maximilian Lutz ◽  
Martin Möckel ◽  
Tobias Lindner ◽  
Christoph J. Ploner ◽  
Mischa Braun ◽  
...  
Keyword(s):  
Emergency Care ◽  
Final Diagnosis ◽  
Class I ◽  
Prehospital Emergency Care ◽  
Unknown Etiology ◽  
Care Providers ◽  
Cohen’S Kappa ◽  
Disorder Of Consciousness ◽  
Cohen's Kappa ◽  
Suspected Diagnosis

Abstract Background Management of patients with coma of unknown etiology (CUE) is a major challenge in most emergency departments (EDs). CUE is associated with a high mortality and a wide variety of pathologies that require differential therapies. A suspected diagnosis issued by pre-hospital emergency care providers often drives the first approach to these patients. We aim to determine the accuracy and value of the initial diagnostic hypothesis in patients with CUE. Methods Consecutive ED patients presenting with CUE were prospectively enrolled. We obtained the suspected diagnoses or working hypotheses from standardized reports given by prehospital emergency care providers, both paramedics and emergency physicians. Suspected and final diagnoses were classified into I) acute primary brain lesions, II) primary brain pathologies without acute lesions and III) pathologies that affected the brain secondarily. We compared suspected and final diagnosis with percent agreement and Cohen’s Kappa including sub-group analyses for paramedics and physicians. Furthermore, we tested the value of suspected and final diagnoses as predictors for mortality with binary logistic regression models. Results Overall, suspected and final diagnoses matched in 62% of 835 enrolled patients. Cohen’s Kappa showed a value of κ = .415 (95% CI .361–.469, p < .005). There was no relevant difference in diagnostic accuracy between paramedics and physicians. Suspected diagnoses did not significantly interact with in-hospital mortality (e.g., suspected class I: OR .982, 95% CI .518–1.836) while final diagnoses interacted strongly (e.g., final class I: OR 5.425, 95% CI 3.409–8.633). Conclusion In cases of CUE, the suspected diagnosis is unreliable, regardless of different pre-hospital care providers’ qualifications. It is not an appropriate decision-making tool as it neither sufficiently predicts the final diagnosis nor detects the especially critical comatose patient. To avoid the risk of mistriage and unnecessarily delayed therapy, we advocate for a standardized diagnostic work-up for all CUE patients that should be triggered by the emergency symptom alone and not by any suspected diagnosis.

Sign in / Sign up

Export Citation Format

Share Document