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Maternal platelet-activating anti–platelet factor 4 antibodies led to cerebral venous sinus thrombosis, thrombocytopenia, hyperfibrinolysis, and cerebral bleeding in a neonate.

Der Autor erörtert das bildungstheoretische und didaktische Potential des Resonanzkonzepts von Rosa und geht u.a. der Frage nach, wie sich der kommunikative Erfolg des Begriffs zur Analyse pädagogischer Interaktionen erklären lässt. (DIPF/Orig.)

Background: Antiphospholipid antibody (aPL) is the most important acquired thrombophilia. Thrombotic risk assessment in these patients must be improved by evaluating new biomarkers. FXI is an excellent candidate, as it is a phospholipid binding protein involved in coagulation and inflammation, high FXI levels increases the risk of thrombosis, and FXI deficiency protects against thrombosis. Aims: To evaluate the prognostic role of FXI in aPL Methods: Cross-sectional and observational study of aPL patients ≥ 18 years recruited in a single center. Clinical, analytical, and epidemiological variables were analyzed. Biochemical and functional evaluation of plasma FXI was done by western blotting and two coagulation assays (FXI:C). Molecular analysis of F11 gene (sequencing and MLPA) was done in cases with FXI deficiency. Primary study outcome was to identify a role for FXI levels in the thrombotic risk of aPL patients. Results: 194 participants were included, 82 asymptomatic aPL (AaPL) and 112 with antiphospholipid syndrome (APS). FXI:C values were significantly higher in patients with APS than AaPL. Cases with high FXI (>150%) were 14 times higher in the APS group (OR= 14,95; 95% CI: 1.95-114.83; p= 0.009). In contrast, cases with FXI deficiency (<70%) were 4 times higher in the AaPL group (OR= 4.93; 95% CI: 1.31-18.54; p= 0.018). FXI deficiency in aPL may be caused by genetic defects, but it is mainly caused by an inhibitor. Summary/Conclusion: This is the first study showing a prognostic role of FXI levels in patients with aPL. High levels increase the risk of APS while deficiency, either congenital or acquired by the aPL, protects against thrombosis.

Antibodies to phospholipids (aPL) and associated proteins are a hallmark in the diagnosis of anti-phospholipid syndrome (APS). Those included in the classification criteria are the lupus anticoagulant (LA) and the IgG and IgM isotypes of anticardiolipin (aCL) and anti-beta-2 glycoprotein I (β2GPI) antibodies. Non-classification criteria markers such as autoantibodies that recognize the phosphatidylserine/prothrombin (aPS/PT) complex have been proposed as biomarkers for APS. Studies of aPS/PT antibodies have shown a strong correlation to clinical manifestations and LA. We aimed to study the value and the persistence of aPS/PT IgG and IgM antibodies in a cohort of consecutive patients with clinical suspicion of APS and their utility as thrombotic risk markers. Our study, with 103 patients, demonstrates that persistently positive results for aPS/PT IgG antibodies were significantly associated with APS classification, thrombosis, triple aPL positivity, LA positive result, and the Global APS Score (GAPSS) > than 9 points (p < 0.01, for each condition). On the other hand, no association was seen with pregnancy morbidity (p = 0.56) and SLE (p = 0.07). Persistence of aPS/PT antibodies, defined according to the current laboratory classification criteria, likely improves the diagnosis and clinical assessment of patients with APS.

Die Warmebehandlung von Verbundwalzen ist ein kritischer Prozessschritt, in dessen Verlauf aufgrund der unterschiedlichen thermophysikalischen Eigenschaften der verwendeten Werkstoffe grose innere Spannungen auftreten konnen. Ziel dieser Arbeit war die Erstellung eines parametrisierten FE-Modells zur einfachen Abbildung unterschiedlicher Warmebehandlungsprozessfuhrungen mit dem Ziel, neue Werkstoffe und Warmebehandlungsrouten gefahrlos einfuhren und erproben zu konnen. Diese Arbeit prasentiert die experimentellen Vorarbeiten, den Aufbau und Validierung des Simulationsmodells in Bezug auf die Warmeleitungssimulation sowie die Abschatzung der Spannungsentwicklung durch die mechanische Simulation.

ABSTRACTSepsis is a serious health condition worldwide, affecting more than 30 million people globally each year. In 2017, the World Health Organization (WHO) adopted a resolution on sepsis: “improving the prevention, diagnosis and clinical management of sepsis”, with the aim of improving early diagnosis, management and prevention to save lives. Blood culture (BC) is generally used to diagnose sepsis because of the low quantity of microbes occurring in the blood during such infections. However, approximately 50% of bloodstream infections (BSI) give negative BC, this figure being higher for sepsis, which delays the start of appropriate antimicrobial therapy. This prospective study evaluated a multiplex real-time polymerase chain reaction, the MagicplexTM Sepsis test (MP), for the detection of pathogens from whole blood, comparing it to routine BC. We analysed 809 blood samples from 636 adult patients, with 132/809 (16.3%) of the samples positive for one or more relevant microorganism according to BC and/or MP. The sensitivity and specificity of MP were 29% and 95%, respectively, while the level of agreement between BC and MP was 87%. The rate of contaminated samples was higher for BC (10%) than MP (4.8%) (P &lt; 0.001). Patients with only MP-positive samples were more likely to be on antimicrobial treatment (47%) than those with only BC-positive samples (18%) (P = 0.002). In summary, the MP test reduces the time taken to identify the microbial pathogen, improving the diagnosis of BSI in patients on antibiotic treatment.