A Novel Fibrinolysis Resistance Capacity Assay Can Detect Fibrinolytic Phenotypes in Trauma Patients.

Background:  To evaluate residual fibrinolysis resistance activity (FRA) in plasma, a detergent-modified plasma clot lysis assay time (dPCLT) was established in which α2-antiplasmin (A2AP) and plasminogen activator inhibitor type 1 (PAI-1) are inactivated without impacting protease activity. We applied this novel assay to severely injured trauma patients' plasma.

Material And Methods:  Tissue-type plasminogen activator (tPA)-induced plasma clot lysis assays were conducted after detergents- (dPCLT) or vehicle- (sPCLT) treatment, and time to 50% clot lysis was measured ("transition midpoint", T ).

The tissue-plasminogen activator-challenged thromboelastography provides a comprehensive assessment of fibrinolysis in the severely injured.

Background: Tissue-plasminogen activator-challenged thromboelastography (tPA-TEG) predicts massive transfusion and mortality better than conventional rapid thromboelastography (rTEG), with little concordance between their lysis values (LY30). We hypothesized that the main fibrinolytic inhibitors plasminogen activator inhibitor-1 (PAI-1) and α-2 antiplasmin (A2AP), as well as markers of fibrinolytic activation (plasmin-antiplasmin [PAP], tPA-PAI-1 complex, tPA activity), would correlate more strongly with tPA-TEG versus rTEG LY30 and may explain the recent findings of four distinct fibrinolytic phenotypes in trauma based on these two TEG methodologies.

Methods: Adult trauma patients (n = 56) had tPA-TEG, rTEG, and plasma obtained on arrival to the emergency department with institutional review board approval.

Standing or Very Low-Intensity Cycling as Sedentary Breaks: Does Physical Activity Level Matter?

Background: Active breaks and very low- to low-intensity exercises such as walking or cycling at an active desk have been shown to significantly counteract the negative effect of prolonged sedentary behaviors. The objective was to investigate the effect of physical activity level (PAL) on changes in energy expenditure (EE), heart rate, and substrate oxidation from sit-to-stand and sit-to-light cycling.

Methods: Fifty healthy young males and females (age: 23.

Covert Breast Cancer Metastasis to the Gastrointestinal Tract: Is Extra Vigilance Needed?

Breast cancer (BC) is a common cancer in females. Spread to the gastrointestinal tract is rare. This is a 61-year-old woman with history of T2N0M0 lobular BC treated 5 years earlier.