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  1. Article ; Online: Extracellular vesicles are a late marker of inflammation, hypercoagulability and COVID-19 severity.

    Barion, Bárbara Gomes / Rocha, Tania Rubia Flores da / Ho, Yeh-Li / Mazetto Fonseca, Bruna de Moraes / Okazaki, Erica / Rothschild, Cynthia / Stefanello, Bianca / Rocha, Vanderson Geraldo / Villaça, Paula Ribeiro / Orsi, Fernanda A

    Hematology, transfusion and cell therapy

    2024  Volume 46, Issue 2, Page(s) 176–185

    Abstract: Exacerbated inflammation and coagulation are a hallmark of COVID-19 severity. Extracellular vesicles (EVs) are intercellular transmitters involved in inflammatory conditions, which are capable of triggering prothrombotic mechanisms. Since the release of ... ...

    Abstract Exacerbated inflammation and coagulation are a hallmark of COVID-19 severity. Extracellular vesicles (EVs) are intercellular transmitters involved in inflammatory conditions, which are capable of triggering prothrombotic mechanisms. Since the release of EVs is potentially associated with COVID-19-induced coagulopathy, the aim of this study was to evaluate changes in inflammation- and hypercoagulability-related EVs during the first month after symptom onset and to determine whether they are associated with disease severity. Blood samples of patients with mild or severe forms of the disease were collected on three occasions: in the second, third and fourth weeks after symptom onset for the quantification by flow cytometry of CD41A (platelet glycoprotein IIb/IIIa), CD162 (PSGL-1), CD31 (PECAM-1) and CD142 cells (tissue factor). Analysis of variance (ANOVA) with repeated measures, Kruskal-Wallis and correlation tests were used. Eighty-five patients were enrolled, 71% of whom had mild disease. Seventeen uninfected individuals served as controls. Compared to controls, both mild and severe COVID-19 were associated with higher EV-CD31
    Language English
    Publishing date 2024-02-01
    Publishing country Brazil
    Document type Journal Article
    ISSN 2531-1387
    ISSN (online) 2531-1387
    DOI 10.1016/j.htct.2023.12.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Safety and efficacy of splenectomy for the treatment of chronic immune thrombocytopenia.

    Saldanha, Artur / Orsi, Fernanda A / Okazaki, Erica / Rothschild, Cynthia / Prestes, Paula / Stefanello, Bianca / Alves, Lucas / Rocha, Vanderson / Villaca, Paula

    Annals of hematology

    2022  Volume 101, Issue 12, Page(s) 2781–2784

    MeSH term(s) Humans ; Splenectomy ; Purpura, Thrombocytopenic, Idiopathic/surgery ; Platelet Count ; Treatment Outcome
    Language English
    Publishing date 2022-09-29
    Publishing country Germany
    Document type Letter
    ZDB-ID 1064950-5
    ISSN 1432-0584 ; 0939-5555 ; 0945-8077
    ISSN (online) 1432-0584
    ISSN 0939-5555 ; 0945-8077
    DOI 10.1007/s00277-022-04985-7
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    Uh III Zs.181: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Persistent hypofibrinolysis in severe COVID-19 associated with elevated fibrinolysis inhibitors activity.

    Okazaki, Erica / Barion, Bárbara Gomes / da Rocha, Tania Rubia Flores / Di Giacomo, Giovanna / Ho, Yeh-Li / Rothschild, Cynthia / Fatobene, Giancarlo / de Carvalho Moraes, Bruna Del Guerra / Stefanello, Bianca / Villaça, Paula Ribeiro / Rocha, Vanderson Geraldo / Orsi, Fernanda Andrade

    Journal of thrombosis and thrombolysis

    2024  Volume 57, Issue 4, Page(s) 721–729

    Abstract: Hypercoagulability and reduced fibrinolysis are well-established complications associated with COVID-19. However, the timelines for the onset and resolution of these complications remain unclear. The aim of this study was to evaluate, in a cohort of ... ...

    Abstract Hypercoagulability and reduced fibrinolysis are well-established complications associated with COVID-19. However, the timelines for the onset and resolution of these complications remain unclear. The aim of this study was to evaluate, in a cohort of COVID-19 patients, changes in coagulation and fibrinolytic activity through ROTEM assay at different time points during the initial 30 days following the onset of symptoms in both mild and severe cases. Blood samples were collected at five intervals after symptoms onset: 6-10 days, 11-15 days, 16-20 days, 21-25 days, and 26-30 days. In addition, fibrinogen, plasminogen, PAI-1, and alpha 2-antiplasmin activities were determined. Out of 85 participants, 71% had mild COVID-19. Twenty uninfected individuals were evaluated as controls. ROTEM parameters showed a hypercoagulable state among mild COVID-19 patients beginning in the second week of symptoms onset, with a trend towards reversal after the third week of symptoms. In severe COVID-19 cases, hypercoagulability was observed since the first few days of symptoms, with a tendency towards reversal after the fourth week of symptoms onset. A hypofibrinolytic state was identified in severe COVID-19 patients from early stages and persisted even after 30 days of symptoms. Elevated activity of PAI-1 and alpha 2-antiplasmin was also detected in severe COVID-19 patients. In conclusion, both mild and severe cases of COVID-19 exhibited transient hypercoagulability, reverted by the end of the first month. However, severe COVID-19 cases sustain hypofibrinolysis throughout the course of the disease, which is associated with elevated activity of fibrinolysis inhibitors. Persistent hypofibrinolysis could contribute to long COVID-19 manifestations.
    MeSH term(s) Humans ; COVID-19 ; Fibrinolysis ; Plasminogen Activator Inhibitor 1/pharmacology ; Antifibrinolytic Agents ; Post-Acute COVID-19 Syndrome ; Thrombophilia
    Chemical Substances Plasminogen Activator Inhibitor 1 ; Antifibrinolytic Agents
    Language English
    Publishing date 2024-03-25
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1230645-9
    ISSN 1573-742X ; 0929-5305
    ISSN (online) 1573-742X
    ISSN 0929-5305
    DOI 10.1007/s11239-024-02961-8
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4352: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Suicidal ideation in medical inpatients: psychosocial and clinical correlates.

    Furlanetto, Letícia M / Stefanello, Bianca

    General hospital psychiatry

    2011  Volume 33, Issue 6, Page(s) 572–578

    Abstract: Objective: To identify psychosocial and clinical correlates of suicidal ideation in medical inpatients.: Method: In a cross-sectional study, all adults consecutively admitted to the medical wards of a University Hospital had their names recorded and ... ...

    Abstract Objective: To identify psychosocial and clinical correlates of suicidal ideation in medical inpatients.
    Method: In a cross-sectional study, all adults consecutively admitted to the medical wards of a University Hospital had their names recorded and were randomized and evaluated during the first week of admission. Suicidal ideation was assessed using Item 9 of Patient Health Questionnaire-9. The Beck Depression Inventory, the Beck Anxiety Inventory, the WHO Subjective well-being scale, the Charlson Comorbidity Index and other numerical rating scales (pain and self-reported physical illness severity) were used. Patients with less than four confidants were considered with poor social support. The Student's t test, Mann-Whitney U test, chi-square test and stepwise logistic regression analysis were used.
    Results: Of the 1092 patients who composed the sample, 7.2% reported having suicidal ideation. After adjusting for psychosocial and clinical confounders, prior suicide attempts (OR: 4.41; 95% CI: 2.12-9.15; P<.001), depressive symptoms (OR: 1.11; 95% CI: 1.06-1.17; P<.001), severe anxiety symptoms (OR: 3.04; 95% CI: 1.47-6.26; P=.003) and poor social support (OR: 2.02; 95% CI:1.03-3.96; P=.04) were independently associated with suicidal ideation.
    Conclusions: Three out of the four correlates of suicidal ideation in medical inpatients are potentially modifiable factors: severe anxiety, depressive symptoms and poor social support. The fourth variable, prior suicide attempts, is not modifiable but should serve as a red flag to suspect and investigate current suicide risk. These findings highlight the importance of suicidal ideation as a proxy for the distress that is incumbent upon physicians to manage if they wish to provide excellent and comprehensive inpatient care.
    MeSH term(s) Cross-Sectional Studies ; Female ; Humans ; Inpatients/psychology ; Logistic Models ; Male ; Mental Disorders/psychology ; Middle Aged ; Psychiatric Status Rating Scales ; Psychology ; Severity of Illness Index ; Social Support ; Statistics, Nonparametric ; Stress, Psychological/psychology ; Suicidal Ideation
    Language English
    Publishing date 2011-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 392299-6
    ISSN 1873-7714 ; 0163-8343
    ISSN (online) 1873-7714
    ISSN 0163-8343
    DOI 10.1016/j.genhosppsych.2011.08.002
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    Zs.A 1584: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Safety and efficacy of cryoprecipitate-poor plasma as a replacement fluid for therapeutic plasma exchange in thrombotic thrombocytopenic purpura: a single center retrospective evaluation.

    Stefanello, Bianca / De Paula, Erich Vinícius / Andrade Orsi, Fernanda / Comenalli Marques, Jose Francisco / Gasparotto Roveri, Eduardo / Pereira Colella, Marina / Castro Ozelo, Margareth / Maria Annichino-Bizzacchi, Joyce / Addas-Carvalho, Marcelo

    Journal of clinical apheresis

    2014  Volume 29, Issue 6, Page(s) 311–315

    Abstract: Introduction: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy caused by decreased activity of ADAMTS13, resulting in reduced clearance of ultralarge von Willebrand factor (VWF) multimers. Treatment of TTP is therapeutic plasma ... ...

    Abstract Introduction: Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy caused by decreased activity of ADAMTS13, resulting in reduced clearance of ultralarge von Willebrand factor (VWF) multimers. Treatment of TTP is therapeutic plasma exchange (TPE) with replacement with fresh frozen plasma (FFP). Cryoprecipitate-poor plasma (CPP) is a plasma product with lower concentrations of large VWF multimers, and similar amounts of ADAMTS13. CPP is regarded as at least as efficacious as FFP in TTP but evidence of additional benefits has not been demonstrated. Furthermore, there are limited data on the frequency of adverse events associated with CPP.
    Material and methods: In our center, the choice between CPP and FFP is performed before the 1st TPE session at the physicians' discretion. Here, we retrospectively evaluated the efficacy and safety of CPP based on the number of sessions, volume of plasma exposure, frequency of exacerbations/relapses, and adverse events.
    Results: Fourteen patients with newly diagnosed TTP were included in this analysis. The proportion of CPP:FFP use was 5:9. There were no significant differences in age, gender, initial hemoglobin, platelet count, LDH, or etiology of TTP between groups. We observed a trend toward a higher number of TPE sessions and higher plasma exposure in CPP, compared to FFP-treated patients. Acute exacerbations were more frequent among patients treated with CPP (OR 26.6; 95%CI 1.01-703.51; P = 0.03). Mild allergic reactions were the most common treatment-related adverse event in both groups.
    Discussion: Our data suggest that CPP should not be used as 1st line treatment for newly diagnosed TTP patients.
    MeSH term(s) ADAM Proteins/blood ; ADAMTS13 Protein ; Adult ; Chills/etiology ; Factor VIII ; Female ; Fever/etiology ; Fibrinogen ; Gastrointestinal Diseases/etiology ; Humans ; Hypersensitivity/etiology ; Male ; Middle Aged ; Plasma ; Plasma Exchange/adverse effects ; Plasma Exchange/methods ; Purpura, Thrombotic Thrombocytopenic/therapy ; Recurrence ; Retrospective Studies ; Young Adult
    Chemical Substances cryoprecipitate coagulum ; Factor VIII (9001-27-8) ; Fibrinogen (9001-32-5) ; ADAM Proteins (EC 3.4.24.-) ; ADAMTS13 Protein (EC 3.4.24.87) ; ADAMTS13 protein, human (EC 3.4.24.87)
    Language English
    Publishing date 2014-12
    Publishing country United States
    Document type Comparative Study ; Evaluation Studies ; Journal Article ; Observational Study
    ZDB-ID 604912-6
    ISSN 1098-1101 ; 0733-2459
    ISSN (online) 1098-1101
    ISSN 0733-2459
    DOI 10.1002/jca.21336
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1831: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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