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- Carlsson, Lena E, et al.
(författare)
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Platelet receptor and clotting factor polymorphisms as genetic risk factors for thromboembolic complications in heparin-induced thrombocytopenia.
- 2003
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Ingår i: Pharmacogenetics. - 0960-314X .- 1473-561X. ; 13:5, s. 253-8
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Tidskriftsartikel (refereegranskat)abstract
- Heparin-induced thrombocytopenia (HIT) is an immune mediated adverse reaction to heparin treatment often associated with limb- and/or life-threatening thromboembolic complications (TECs). Presently, no prognostic marker has been identified that allows differentiation between mildly (isolated thrombocytopenia) and severely (TECs) affected patients. This study assesses the impact of platelet glycoprotein- and clotting factor polymorphisms in HIT-patients with isolated thrombocytopenia compared to HIT-patients with TECs. Sixty-three HIT-patients with isolated thrombocytopenia and 79 HIT-patients with HIT-related TECs were genotyped for GPIIb-IIIa polymorphisms (HPA-1, HPA-3), GPIa-IIa polymorphisms (HPA-5, GPIaC807T), GPIb-IX-V polymorphisms (HPA-2, Kozak-5, VNTR), and clotting factor polymorphisms (FV-Leiden R506Q, prothrombin PT-G20210A and MTHFR C677T). Women more often presented with TECs than men (P = 0.04). No differences in genotype frequencies could be seen on comparing HIT-patients with and without TECs. Analysing men and women separately, the C allele of the Kozak polymorphism was overrepresented in men who developed TECs (P = 0.034). The enhanced risk of women to develop HIT-associated TECs remains unexplained but it is potentially important in view of recent data on sex-hormone related changes of haemostasis. There was no correlation between platelet glycoprotein- and clotting factor polymorphisms and the risk to develop HIT-associated TECs. An association between the development of TECs and the Kozak-5C allele could be seen among male patients. However, this would need to be assessed in further larger studies. Most likely, the high levels of thrombin generation during acute HIT are so procoagulant that less pronounced risk factors such as polymorphisms are overshadowed.
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| 2. |
- Tonderski, Karin S., et al.
(författare)
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Våtmarker : Närsaltsfällor och/eller myllrande mångfald?
- 2003
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Ingår i: Vatten: tidskrift för vattenvård. - Nykvarn : Föreningen Vatten. - 0042-2886. ; 59:4, s. 259-270
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Tidskriftsartikel (refereegranskat)abstract
- This paper summarizes the state-of-the-art with respect to wetlands for nutrient removal and biodiversity enhancement, as expressed at a research workshop in December 2002. In the end of 2002, 260 and 884 wetlands had been constructed in Sweden with subsidies from LIP and the European Union, respectively. Most frequently, the aims were to remove nutrients from water and enhance biodiversity. The question raised is if we know how to design multifunctional wetlands. Should a wetland be deep or shallow, with or without macrophytes to be an efficient nutrient sink? Diverging opinions are presented, but generally it appears that fairly shallow wetlands at least partly covered by emergent macrophytes are favourable. The importance of extreme high flows and hydraulic short-circuiting is highlighted, and Danish and Norwegian approaches to wetlands construction are presented. Also, there is a risk that nutrient retaining wetlands develop a fairly trivial flora and fauna unless special care is taken. Intentional establishment of desirable and less common species, as well as creation of a variation of depth gradients to favour such species are such measures. Others are allowing for water level variations, as well as vegetation management such as grazing and harvesting.
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