SNaPshot

SNaPshot
  • 文章类型: Journal Article
    组织特异性差异甲基化区域的鉴定为法医遗传学领域做出了重大贡献,特别是在体液识别中,对于将证据与犯罪联系起来至关重要。在分析DNA甲基化的各种方法中,SNaPshot测定法在许多研究中得到了广泛的研究。然而,人们对探索替代方法的兴趣越来越大,例如使用大规模平行测序(MPS),可以同时处理大量的样本。这项研究比较了使用9种胞嘧啶-磷酸-鸟嘌呤标记进行体液鉴定的SNaPshot和MPS多重测定。分析了112个样本,包括血,唾液,阴道液,经血,还有精液,两种方法都表现出高灵敏度和特异性,表明他们在法医调查中的可靠性。通过两种方法正确鉴定了总共92.0%的样品。尽管这两种方法都能准确识别所有血液,唾液,还有精液样本,除靶基因座外,一些阴道液样本在非靶基因座处显示出非预期的甲基化信号.在月经血样本的情况下,由于它们的复杂性,采用独立的分型标准,成功的经血分型是可能的,而一些样本显示出与阴道液相似的特征。MPS方法在阴道液样本中效果更好,SNaPshot方法在月经血样本中表现更好。本研究基于SNaPshot和MPS方法的特点,为体液识别提供了有价值的见解,这可能有助于更有效的取证应用。
    The identification of tissue-specific differentially methylated regions has significantly contributed to the field of forensic genetics, particularly in body fluid identification crucial for linking evidence to crimes. Among the various approaches to analyzing DNA methylation, the SNaPshot assay has been popularly studied in numerous researches. However, there is a growing interest in exploring alternative methods such as the use of massively parallel sequencing (MPS), which can process a large number of samples simultaneously. This study compares SNaPshot and MPS multiplex assays using nine cytosine-phosphate-guanine markers for body fluid identification. As a result of analyzing 112 samples, including blood, saliva, vaginal fluid, menstrual blood, and semen, both methods demonstrated high sensitivity and specificity, indicating their reliability in forensic investigations. A total of 92.0% samples were correctly identified by both methods. Although both methods accurately identified all blood, saliva, and semen samples, some vaginal fluid samples showed unexpected methylation signals at nontarget loci in addition to the target loci. In the case of menstrual blood samples, due to their complexity, independent typing criteria were applied, and successful menstrual blood typing was possible, whereas a few samples showed profiles similar to vaginal fluid. The MPS method worked better in vaginal fluid samples, and the SNaPshot method performed better in menstrual blood samples. This study offers valuable insights into body fluid identification based on the characteristics of the SNaPshot and MPS methods, which may help in more efficient forensic applications.
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  • 文章类型: Journal Article
    心脏猝死(SCD)在全身尸检后通常显示阴性解剖结果,钾通道的基因突变在SCD的病因中起关键作用。我们建立了一个可行的系统来检测SCD相关突变,并调查了中国人群中KCNQ1和KCNH2基因的突变情况。我们建立了结合多重PCR的突变检测系统,SNaPshot技术,和毛细管电泳。我们使用已建立的测定法对60个阴性解剖结构的SCD和50个对照中的KCNQ1和KCNH2基因的101个推定突变进行了基因分型,并比较了奇数比(OR)。在KCNQ1基因中鉴定了四种编码变体:S546S,I145I,P448R,和G643S。与对照相比,I145I和S546S的突变在SCD中没有显著差异。21例SCD个体(35%)和1例对照个体(2%)在P448R显示C/G基因型(OR=17.5,95%CI[2.40-127.82])。24个SCD个体(40%)和1个对照个体(2%)在G643S显示C/G基因型(OR=20.0,95%CI[2.75-145.25])。我们建立了快速筛选KCNQ1和KCNH2基因中推定的SCD相关突变的稳健测定法。我们研究中的新测定法很容易适用于大多数实验室,而无需新的专用设备。我们的方法将满足常规DNA实验室对SCD突变筛查的日益增长的要求,并将有助于筛查那些死于SCD及其亲属的突变。
    Sudden Cardiac Death (SCD) often shows negative anatomy results after a systemic autopsy and the gene mutations of potassium channel play a key role in the etiology of SCD. We established a feasible system to detect SCD-related mutations and investigated the mutations at KCNQ1 and KCNH2 genes in the Chinese population. We established a mutation detection system combined with multiplex PCR, SNaPshot technique, and capillary electrophoresis. We genotyped 101 putative mutations at KCNQ1 and KCNH2 genes in 60 SCD of negative anatomy and 50 controls using the established assay and compared Odd Ratio (OR). Four coding variants were identified in the KCNQ1 gene: S546S, I145I, P448R, and G643S. The mutations of I145I and S546S did not differ significantly in the SCD compared with controls. 21 SCD individuals (35 %) and 1 control individual (2 %) showed a genotype of C/G at P448R (OR = 17.5, 95 % CI [2.40-127.82]). 24 SCD individuals (40 %) and 1 control individual (2 %) showed a genotype of C/G at G643S (OR = 20.0, 95 % CI [2.75-145.25]). We established a robust assay for rapid screening the putative SCD-related mutations in KCNQ1 and KCNH2 genes. The new assay in our study is easily amenable to the majority of laboratories without the need for new specialized equipment. Our method will meet the increasing requirement of mutation screening for SCD in regular DNA laboratories and will help screen mutations in those dead of SCD and their relatives.
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  • 文章类型: Journal Article
    识别体液和器官组织非常重要,因为它们可以在刑事调查中提供关键证据,并帮助法院做出明智的决定。主要通过评估生物来源,并可能在活动水平直至死亡或致命损害。在这项研究中,从Illumina的9个器官组织的甲基化EPIC阵列数据中鉴定出器官组织特异性CpG标记,包括表皮,真皮,心,骨骼肌,血,肾,大脑,肺,还有肝脏,来自10名韩国人的尸检。通过使用43个样本的验证测试,18个低甲基化标记,每种器官组织类型都有两个标记,选择构建SNaPshot测定。设计了涉及正向和反向SBE引物的两个多重测定,以帮助研究者通过重复分析相同的PCR产物的标记来准确地确定所分析的组织样品的器官来源。开发的多路复用显示出高精度,在来自10名亚洲人的尸检的88个样本中,对9种器官组织类型的存在实现100.0%的正确检测。然而,两个肺样本显示血液存在的其他阳性迹象.使用80个尸检样本(心脏,骨骼肌,血,肾皮质,肾髓质,大脑,肺,和肝脏)来自德国的10名个体,显示出总体可比较的结果,正确检测了92.5%样品(80个样品中的74个)中8种器官组织类型的存在。在六个样本的情况下,由于靶组织标志物位点的未甲基化信号缺失,因此无法成功确定正确的组织.这些肺样品中的一个仅显示血液的非预期脱靶信号。观察到的差异可能是由于常规尸检期间样本收集的差异,由于PCR循环仪的技术差异,以及用于信号呼叫的阈值。通过应用更严格的低甲基化阈值,表明存在其他组织类型和脱靶非甲基化信号似乎可以缓解。因此,开发的SNaPshot多重分析对于处理器官组织鉴定的法医调查人员将是有价值的,以及旨在确定犯罪现场情况的检察官和辩方。
    Identifying body fluids and organ tissues is highly significant as they can offer crucial evidence in criminal investigations and aid the court in making informed decisions, primarily through evaluating the biological source and possibly at the activity level up to death or fatal damage. In this study, organ tissue-specific CpG markers were identified from Illumina\'s methylation EPIC array data of nine organ tissues, including epidermis, dermis, heart, skeletal muscle, blood, kidney, brain, lung, and liver, from autopsies of 10 Koreans. Through the validation test using 43 samples, 18 hypomethylation markers, with two markers for each organ tissue type, were selected to construct a SNaPshot assay. Two multiplex assays involving forward and reverse SBE primers were designed to help investigators accurately determine the organ origin of the analyzed tissue samples through repeated analysis of the same PCR products for markers. The developed multiplex demonstrated high accuracy, achieving 100.0 % correct detection of the presence of nine organ tissue types in 88 samples from autopsies of 10 Asians. However, two lung samples showed additional positive indications of the presence of blood. An interlaboratory comparison using 80 autopsy samples (heart, skeletal muscle, blood, kidney cortex, kidney medulla, brain, lung, and liver) from 10 individuals in Germany revealed overall comparable results with correct detection of the presence of eight organ tissue types in 92.5 % samples (74 of 80 samples). In the case of six samples, it was impossible to determine the correct tissue successfully due to drop-outs of unmethylation signals at target tissue marker loci. One of these lung samples revealed only non-intended off-target signals for blood. The observed differences might be due to differences in sample collection during routine autopsy, technical differences due to the PCR cycler, and the threshold used for signal calling. Indicating the presence of additional tissue type and off-target unmethylation signals seems alleviated by applying more stringent hypomethylation thresholds. Therefore, the developed SNaPshot multiplex assays will be valuable for forensic investigators dealing with organ tissue identification, as well as for prosecutors and defense aiming to establish the circumstances that occurred at the crime scene.
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  • 文章类型: Journal Article
    基于荧光的钾通道测定通常运行在昂贵的,很难获得,在大多数实验室中不常见的荧光成像动力学读板器。在这里,我们描述了使用辉煌铊快照测定进行终点钾通道测定,因此,它可以在多个平板阅读器平台,在许多实验室中更常见的使用。这些方法将允许用户识别钾通道的调节剂。对于这项工作,我们已经采取了基于FLIPR的动力学模式分子装置方案,并对其进行了调整,以便在终点读板器上使用,例如BMGLabtechPHERAstar,以鉴定CHO细胞中GIRK通道的激活剂。我们证明,两个读板器在功能上都能产生出色的Z'值,这使它们非常适合从SigmaLOPAC1,280筛选集合中找到推论命中。重要的是,该测定也已使用高含量阅读器进行了验证,证明了空间分辨来自混合细胞群体中单个细胞的信号的可能性。这些结果的纲要显示了灵活性,在更常见的读板器上,端点兼容的钾通道测定读数的可及性和功能性。
    Fluorescence-based potassium channel assays are typically run on expensive, hard to obtain, fluorescence imaging kinetic plate readers that are uncommon in most laboratories. Here we describe the use of the Brilliant Thallium Snapshot assay to conduct an endpoint potassium channel assay, so that it can be used across multiple plate reader platforms that are more common in many labs. These methods will allow users to identify modulators of potassium channels. For this work, we have taken a kinetic mode Molecular Devices FLIPR based protocol and adapted it to be utilized on endpoint plate readers, such as the BMG Labtech PHERAstar, to identify activators of GIRK channels in CHO cells. We demonstrate that both plate readers are functionally competent at generating excellent Z\' values which makes them ideally suited to finding corollary hits from the Sigma LOPAC 1,280 screening collection. Importantly, this assay has also been validated using a high content reader, demonstrating the possibility of spatially resolving signals from individual cells within a mixed cell population. The compendium of these results shows the flexibility, accessibility and functionality of endpoint-compatible potassium channel assay readouts on more common plate readers.
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  • 文章类型: Journal Article
    在法医病例中处理不平衡混合物时,由于存在口吃峰和大扩增子,短串联重复分析具有挑战性。在这项研究中,我们提出了一种新的遗传标记DIP-TriSNP,在小于230bp的人类基因组中结合了缺失/插入多态性(DIP)和三等位基因单核苷酸多态性。基于多重PCR和SNaPShot,一个小组,包括14个常染色体DIP-TriSNPs和1个Y染色体DIP-SNP,已开发并应用于中国四川102个无关的汉族个体的基因分型,并模拟了混合研究。面板灵敏度可以达到低至0.1ngDNA模板,如获得的结果所示,可以以19:1的最高比例检测到DNA的次要贡献者。在四川汉族人口中,信息性基因型的累积概率达到0.997092,综合辨别力为0.999999998801。据估计,该小组在99.69%的四川汉族人群的至少一个基因座中检测到两个以上的等位基因。总之,DIP-TriSNPs已显示出很有希望作为一种创新的DNA标记,用于识别不平衡DNA混合物中的次要贡献者。提供优势,如短放大,多态性增加,和提高灵敏度。
    Short tandem repeat analysis is challenging when dealing with unbalanced mixtures in forensic cases due to the presence of stutter peaks and large amplicons. In this research, we propose a novel genetic marker called DIP-TriSNP, which combines deletion/insertion polymorphism (DIP) with tri-allelic single nucleotide polymorphism in less than 230 bp length of human genome. Based on multiplex PCR and SNaPShot, a panel, including 14 autosomal DIP-TriSNPs and one Y chromosomal DIP-SNP, had been developed and applied to genotyping 102 unrelated Han Chinese individuals in Sichuan of China and simulated a mixture study. The panel sensitivity can reach as low as 0.1 ng DNA template, and the minor contributor of DNA can be detected with the highest ratio of 19:1, as indicated by the obtained results. In the Sichuan Han population, the cumulative probability of informative genotypes reached 0.997092, with a combined power of discrimination of 0.999999998801. The panel was estimated to detect more than two alleles in at least one locus in 99.69% of mixtures of the Sichuan Han population. In conclusion, DIP-TriSNPs have shown promising as an innovative DNA marker for identifying the minor contributor in unbalanced DNA mixtures, offering advantages such as short amplifications, increased polymorphism, and heightened sensitivity.
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  • 文章类型: Journal Article
    唾液细菌群落组成与宿主的内部和环境因素有关,在法医实践中具有潜在的应用。16SrRNA基因测序是检测唾液细菌多样性最常用的策略;然而,其平台与通常用于法医应用的毛细管电泳(CE)平台不兼容。因此,我们尝试使用单核苷酸多态性(SNP)检测唾液细菌多样性.唾液细菌多样性在不同的地理位置之间有所不同,使其成为法医地理采购的潜在补充生物标志物。为了评估多重SNaPshot测定的性能,使用多重SNaPshot测定和16SrRNA基因测序分析了来自中国三个地理位置的唾液样本。我们从两个相对丰度较高的唾液属(链球菌和Veillonella)中筛选了SNP,以构建可在CE平台上使用的多重SNaPshot系统。还测试了多重SNaPshot系统的稳定性和灵敏度。使用随机森林分类模型对来自不同地区的样品进行分类,以探索唾液细菌区分地理来源的能力。筛选了六个细菌SNP并构建了多重SNaPshot系统。稳定性结果表明,在本研究中,在室内放置不同天数的唾液染色剂的分型不受影响。三分之二的模拟唾液染色样品显示超过90%的唾液染色样品获得的分型结果,输入0.1μl唾液。基于唾液细菌多样性的主坐标分析结果表明,来自三个不同地理位置的样品之间存在显着差异。基于多重SNaPshot测定的随机森林分类的准确度为66.67%,基于16SrRNA基因测序的准确度为83.33%。总之,这是首次尝试使用多重SNaPshot细菌SNP测定法检测唾液细菌多样性.人类唾液细菌群落组成的地理差异显著,正如多重SNaPshot测定法所揭示的那样;然而,它在区分地理来源方面的表现低于16SrRNA基因测序。这种基于细菌SNP基因座的策略可能有利于在普通法医实验室中检测人类细菌多样性,但需要在更大的样本量和更多的细菌SNP基因座中进行进一步探索。
    Salivary bacterial community composition is associated with the host\'s internal and environmental factors, which have potential applications in forensic practice. The 16S rRNA gene sequencing is the most commonly used strategy for detecting salivary bacterial diversity; however, its platforms are not compatible with capillary electrophoresis (CE) platforms commonly used for forensic applications. Therefore, we attempted to detect the salivary bacterial diversity using a single nucleotide polymorphism (SNP) assay. Salivary bacterial diversity varies among diverse geographic locations, making it a potential supplementary biomarker for forensic geographic sourcing. To evaluate the performance of the multiplex SNaPshot assay, saliva samples from three geographic locations in China were analyzed using the multiplex SNaPshot assay and 16S rRNA gene sequencing. We screened SNPs from two high-relative-abundance salivary genera (Streptococcus and Veillonella) to construct a multiplex SNaPshot system that can be used on the CE platform. The stability and sensitivity of the multiplex SNaPshot system were also tested. A random forest classification model was used to classify samples from different regions to explore the ability of salivary bacteria to discriminate between geographic sources. Six bacterial SNPs were screened and a multiplex SNaPshot system was constructed. The stability results showed that the typing of salivary stains that were placed indoors for different days was not affected in this study. Two-thirds of mocked salivary stain samples showed more than 90% of typing results obtained for salivary stain samples with an input of 0.1 µl saliva. The results of principal coordinate analysis based on salivary bacterial diversity showed significant differences between samples from the three different geographic locations. The accuracy of the random forest classification was 66.67% based on the multiplex SNaPshot assay and 83.33% based on the 16S rRNA gene sequencing. In conclusion, this is the first attempt to detect salivary bacterial diversity using a multiplex SNaPshot bacterial SNP assay. The geographic difference in human salivary bacterial community composition was significant, as revealed by the multiplex SNaPshot assay; however, its performance in discriminating geographic sources was lower than that of 16S rRNA gene sequencing. This strategy based on bacterial SNP loci may favor the detection of human bacterial diversity in common forensic laboratories but requires further exploration in larger sample sizes and more bacterial SNP loci.
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  • 文章类型: Journal Article
    高光谱成像(HSI)是一种新兴的数字病理学模式。这项研究的目的是开发一种扩展景深(EDOF)方法,用于使用快照相机获取的马赛克高光谱图像。EDOF是用于确保图像在所有点处聚焦的技术。在沿z轴的不同位置处获取了一堆苏木精和曙红(H&E)染色的组织学载玻片的马赛克高光谱图像,并用于输出在每个点都聚焦的高光谱组织学图像。比较了三种不同的方法以实现完全聚焦的图像。我们将传统的基于补丁的方法与我们提出的基于增长的方法和基于频带的方法进行了比较。Brenner函数用于定量测量每个测量图像的聚焦质量。结果表明,我们提出的两种方法在定性和定量上都优于基于补丁的方法,基于频带的方法表现最好,因为它除了在空间上之外,还利用了将像素划分为适当的波长,给出了算法更好的测量对比。在速度方面,基于波段的方法是最快的,其次是基于补丁的方法,基于增长的方法是最慢的。我们提出的扩展景深高光谱成像方法可以在数字病理学中立即应用。尤其是整个幻灯片成像,和其他显微成像。
    Hyperspectral imaging (HSI) is an emerging modality for digital pathology. The purpose of this study is to develop an extended depth of field (EDOF) method for mosaic hyperspectral images acquired with a snapshot camera. EDOF is a technique for ensuring that an image is in focus at all points. A stack of mosaicked hyperspectral images of hematoxylin and eosin (H&E)-stained histologic slides were acquired at different positions along the z-axis and used to output a hyperspectral histologic image that was in-focus at every point. Three different methods were compared to achieve a fully focused image. We compared conventional patch-based methods to our proposed growth-based and band-based methods. The Brenner function was used to quantitatively measure the focus quality of each image measured. The results show that both of our proposed methods performed better qualitatively and quantitatively than the patch-based method, with the band-based method performing the best, as it leveraged dividing pixels into their proper wavelengths in addition to spatially, giving the algorithm better contrast to measure. In terms of speed, the band-based method was the fastest, followed by the patch-based method, with the growth-based method being the slowest. Our proposed extended depth of field hyperspectral imaging methods can have immediate applications in digital pathology, especially whole slide imaging, and other microscopic imaging.
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  • 文章类型: Journal Article
    背景:目前的指南建议对有症状的心房颤动(AF)患者采用节律控制策略,而导管消融已被证明是一种比抗心律失常药物更安全、更有效的方法。
    方法:HECMOS是一项全国范围内的心脏病住院患者心肾发病率调查。在这项子研究中,我们纳入了276例有房颤病史的病例,特别是在节奏策略上,和导管消融术在入院前已经进行.
    结果:276例房颤患者(平均年龄:76.4±11.5岁,58%男性),60.9%(N=168)有持续性房颤,39.1%(N=108)有阵发性房颤。54.3%(N=145)的患者以心力衰竭为主要入院原因,14.1%(N=39)因阵发性房颤入院,7.3%(N=20)由于缓慢心律失常的原因,6.5%(N=18)患有急性冠脉综合征。最重要的是,76例(27%)患者存在射血分数降低的心力衰竭.总共只有10名患者(3%,平均年龄59.7岁)接受了AF消融术,同时在37例(13.4%)患者中尝试了电复律.有趣的是,在这个患有心力衰竭的房颤人群中,3.6%(N=10)植入了除颤器(4个单腔),只有1.5%(N=4)的患者有心脏再同步治疗除颤器(CRTD)。
    结论:在住院患者中发现持续性房颤的高患病率,心力衰竭是入院和主要合并症的主要原因。节奏控制策略明显未被充分利用,房颤和心力衰竭患者的CRT-D植入。
    BACKGROUND: Current guidelines recommend a rhythm control strategy in patients with symptomatic atrial fibrillation (AF) while catheter ablation has been shown to be a safer and more efficacious approach than antiarrhythmic medications.
    METHODS: HECMOS was a nationwide snapshot survey of cardiorenal morbidity in hospitalized cardiology patients. In this sub-study, we included 276 cases who had a history of AF, particularly on the rhythm strategy, and catheter ablation procedures had been performed before the index admission.
    RESULTS: Among 276 AF patients (mean age: 76.4 ± 11.5 years, 58 % male), 60.9 % (N = 168) had persistent AF and 39.1 % (N = 108) had paroxysmal AF. Heart failure was the main cause of admission in 54.3 % (N = 145) of the patients, while 14.1 % (N = 39) were admitted due to paroxysmal AF, 7.3 % (N = 20) due to bradyarrhythmic reasons, and 6.5 % (N = 18) suffered from acute coronary syndrome. Most importantly, heart failure with reduced ejection fraction was present in 76 (27 %) patients. Only 10 patients out of the total (3 %, mean age 59.7 years) had undergone AF ablation while electrical cardioversion had been attempted in 37 (13.4 %) patients. Interestingly, in this AF population with heart failure, 3.6 % (N = 10) had a defibrillator implanted (4 single-chamber), and only 1.5 % (N = 4) had a cardiac resynchronization therapy defibrillator (CRT-D).
    CONCLUSIONS: High prevalence of persistent AF was detected in hospitalized patients, with heart failure being the leading cause of admission and main co-morbidity. Rhythm control strategies are notably underused, along with CRT-D implantation in patients with AF and heart failure.
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  • 文章类型: Journal Article
    背景和目的:正确使用口服抗凝药对于非瓣膜性心房颤动(AF)患者的治疗至关重要。左心耳封堵术(LAAC)可用于房颤患者的卒中预防,并有长期抗凝治疗的禁忌症。我们旨在从HECMOS(希腊心肾疾病快照)调查中评估房颤患者的抗凝状态和LAAC适应症。材料和方法:HECMOS是一项全国性的心脏病住院患者心肾发病率快照调查。HECMOS使用电子平台收集2022年3月3日在55个不同心脏科住院的所有患者的人口统计学和临床相关信息。在这项子研究中,我们纳入了已知无机械人工瓣膜或中度至重度二尖瓣狭窄的房颤患者.既往有中风的患者,以前的大出血,抗凝剂依从性差,终末期肾病被认为是LAAC的候选者.结果:我们的分析中包括了256例患者(平均年龄76.6±11.7,男性148例)。他们中的大多数(n=159;62%)患有持续性房颤。CHA2DS2-VASc平均得分为4.28±1.7,而HAS-BLED平均得分为1.47±0.9。3名CHA2DS2-VASc评分为0或1(女性)的患者中有3名进行了不适当的抗凝治疗。18名CHA2DS2-VASc评分为1或2的患者中有16名(如果是女性)接受了抗凝剂。CHA2DS2-VASc评分>1或2(如果是女性)的2335例患者中有31例未进行抗凝治疗。68例NVAF患者存在LAAC的相对适应症(63例仅有一个危险因素,5例有两个并发危险因素)。详细来说,36人曾中风,17例患者有大出血史,15名患者报告抗凝治疗依从性差或无依从性,5名患者的eGFR值<15mL/min/1.73m2,共73个危险因素。此外,33人的HAS-BLED评分≥3。没有记录LAAC治疗。结论:在主要使用NOAC治疗的高血栓栓塞风险心脏病患者人群中,抗凝状态几乎是最佳的。四分之一的房颤患者应进行LAAC筛查。
    Background and Objectives: The proper use of oral anticoagulants is crucial in the management of non-valvular atrial fibrillation (AF) patients. Left atrial appendage closure (LAAC) may be considered for stroke prevention in patients with AF and contraindications for long-term anticoagulant treatment. We aimed to assess anticoagulation status and LAAC indications in patients with AF from the HECMOS (Hellenic Cardiorenal Morbidity Snapshot) survey. Materials and Methods: The HECMOS was a nationwide snapshot survey of cardiorenal morbidity in hospitalized cardiology patients. HECMOS used an electronic platform to collect demographic and clinically relevant information from all patients hospitalized on 3 March 2022 in 55 different cardiology departments. In this substudy, we included patients with known AF without mechanical prosthetic valves or moderate-to-severe mitral valve stenosis. Patients with prior stroke, previous major bleeding, poor adherence to anticoagulants, and end-stage renal disease were considered candidates for LAAC. Results: Two hundred fifty-six patients (mean age 76.6 ± 11.7, 148 males) were included in our analysis. Most of them (n = 159; 62%) suffered from persistent AF. The mean CHA2DS2-VASc score was 4.28 ± 1.7, while the mean HAS-BLED score was 1.47 ± 0.9. Three out of three patients with a a CHA2DS2-VASc score of 0 or 1 (female) were inappropriately anticoagulated. Sixteen out of eighteen patients with a CHA2DS2-VASc score 1 or 2 (if female) received anticoagulants. Thirty-one out of two hundred thirty-five patients with a CHA2DS2-VASc score > 1 or 2 (if female) were inappropriately not anticoagulated. Relative indications for LAAC were present in 68 patients with NVAF (63 had only one risk factor and 5 had two concurrent risk factors). In detail, 36 had a prior stroke, 17 patients had a history of major bleeding, 15 patients reported poor or no adherence to the anticoagulant therapy and 5 had an eGFR value < 15 mL/min/1.73 m2 for a total of 73 risk factors. Moreover, 33 had a HAS-BLED score ≥ 3. No LAAC treatment was recorded. Conclusions: Anticoagulation status was nearly optimal in a high-thromboembolic-risk population of cardiology patients who were mainly treated using NOACs. One out of four AF patients should be screened for LAAC.
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  • 文章类型: Journal Article
    含有血液的混合物经常出现在谋杀和抢劫案件中,他们的身份识别在解决犯罪中起着重要作用。近年来,DNA甲基化标记(CpG)和单核苷酸多态性(SNP)标记的共检测已被证明是鉴定精液及其供体的有前景的工具.然而,关于犯罪现场经常发现的血迹的类似研究尚未报道。在这项研究中,我们使用血液特异性CpG连锁SNP标记(CpG-SNP)进行血液特异性基因分型,并将血液与其供体进行连接.从文献中筛选组织特异性CpG标记物,并通过将亚硫酸氢盐转化与扩增-难治性突变系统(ARMS)技术相结合来进一步验证。同时,在CpG标记上游和下游400bp内选择次要等位基因频率(MAF)大于0.1的相邻SNP标记。使用SNaPshot技术在毛细管电泳(CE)平台上进行SNP基因分型。最后,一个多重面板,包括19个与23个SNP标记相关的血液特异性CpG,以及1种精液特异性CpG,1阴道分泌物特异性CpG,和1个唾液特异性CpG标记,建造成功。该组显示出良好的组织特异性,并且可以有效地鉴定在室温下储存长达9个月并且中度降解(4 Blood-containing mixtures often appear in murder and robbery cases, and their identification plays a significant role in solving crimes. In recent years, the co-detection of DNA methylation markers (CpG) and single nucleotide polymorphism (SNP) markers has been shown to be a promising tool for the identification of semen and its donor. However, similar research on blood stains that are frequently found at crime scenes has not yet been reported. In this study, we employed blood-specific CpG-linked SNP markers (CpG-SNP) for blood-specific genotyping and the linking of blood and its donor. The tissue-specific CpG markers were screened from the literature and further verified by combining bisulfite conversion with amplification-refractory mutation system (ARMS) technology. Meanwhile, adjacent SNP markers with a minor allele frequency (MAF) greater than 0.1 were selected within 400 bp upstream and downstream of the CpG markers. SNP genotyping was performed using SNaPshot technology on a capillary electrophoresis (CE) platform. Finally, a multiplex panel, including 19 blood-specific CpG linked to 23 SNP markers, as well as 1 semen-specific CpG, 1 vaginal secretion-specific CpG, and 1 saliva-specific CpG marker, was constructed successfully. The panel showed good tissue specificity and blood stains stored at room temperature for up to nine months and moderately degraded (4 < DI < 10) could be effectively identified. Moreover, it could also be detected when blood content in the mixed stains was as low as 1%. In addition, 15 ng of DNA used for bisulfite conversion was required for obtaining a complete profile. The cumulative discrimination power of the panel among the Han population of northern China could reach 0.999983. This is the first investigation conducted for the simultaneous identification of blood and its donor regardless of other body fluids included in mixed stains. The successful construction of the panel will play a vital role in the comprehensive analysis of blood-containing mixtures in forensic practice.
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