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1.
  • 2021
  • swepub:Mat__t
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2.
  • 2021
  • swepub:Mat__t
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3.
  • Bravo, L, et al. (author)
  • 2021
  • swepub:Mat__t
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4.
  • Tabiri, S, et al. (author)
  • 2021
  • swepub:Mat__t
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5.
  • Glasbey, JC, et al. (author)
  • 2021
  • swepub:Mat__t
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7.
  • Khatri, C, et al. (author)
  • Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
  • 2021
  • In: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
  • Journal article (peer-reviewed)abstract
    • Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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9.
  • Varela, AR, et al. (author)
  • Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity-GoPA! 2015 and 2020 Surveys
  • 2023
  • In: Journal of physical activity & health. - : Human Kinetics. - 1543-5474 .- 1543-3080. ; 20:2, s. 112-128
  • Journal article (peer-reviewed)abstract
    • Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.
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10.
  • Danesh, John, et al. (author)
  • Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis
  • 2005
  • In: JAMA: The Journal of the American Medical Association. - : American Medical Association (AMA). - 1538-3598 .- 0098-7484. ; 294:14, s. 1799-1809
  • Research review (peer-reviewed)abstract
    • CONTEXT: Plasma fibrinogen levels may be associated with the risk of coronary heart disease (CHD) and stroke. OBJECTIVE: To assess the relationships of fibrinogen levels with risk of major vascular and with risk of nonvascular outcomes based on individual participant data. DATA SOURCES: Relevant studies were identified by computer-assisted searches, hand searches of reference lists, and personal communication with relevant investigators. STUDY SELECTION: All identified prospective studies were included with information available on baseline fibrinogen levels and details of subsequent major vascular morbidity and/or cause-specific mortality during at least 1 year of follow-up. Studies were excluded if they recruited participants on the basis of having had a previous history of cardiovascular disease; participants with known preexisting CHD or stroke were excluded. DATA EXTRACTION: Individual records were provided on each of 154,211 participants in 31 prospective studies. During 1.38 million person-years of follow-up, there were 6944 first nonfatal myocardial infarctions or stroke events and 13,210 deaths. Cause-specific mortality was generally available. Analyses involved proportional hazards modeling with adjustment for confounding by known cardiovascular risk factors and for regression dilution bias. DATA SYNTHESIS: Within each age group considered (40-59, 60-69, and > or =70 years), there was an approximately log-linear association with usual fibrinogen level for the risk of any CHD, any stroke, other vascular (eg, non-CHD, nonstroke) mortality, and nonvascular mortality. There was no evidence of a threshold within the range of usual fibrinogen level studied at any age. The age- and sex- adjusted hazard ratio per 1-g/L increase in usual fibrinogen level for CHD was 2.42 (95% confidence interval [CI], 2.24-2.60); stroke, 2.06 (95% CI, 1.83-2.33); other vascular mortality, 2.76 (95% CI, 2.28-3.35); and nonvascular mortality, 2.03 (95% CI, 1.90-2.18). The hazard ratios for CHD and stroke were reduced to about 1.8 after further adjustment for measured values of several established vascular risk factors. In a subset of 7011 participants with available C-reactive protein values, the findings for CHD were essentially unchanged following additional adjustment for C-reactive protein. The associations of fibrinogen level with CHD or stroke did not differ substantially according to sex, smoking, blood pressure, blood lipid levels, or several features of study design. CONCLUSIONS: In this large individual participant meta-analysis, moderately strong associations were found between usual plasma fibrinogen level and the risks of CHD, stroke, other vascular mortality, and nonvascular mortality in a wide range of circumstances in healthy middle-aged adults. Assessment of any causal relevance of elevated fibrinogen levels to disease requires additional research.
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13.
  • Riedel, M., et al. (author)
  • Improving e-Science with Interoperability of the e-Infrastructures EGEE and DEISA
  • 2008
  • In: MIPRO 2008 - 31st International Convention Proceedings. - 9789532330366 ; , s. 225-231
  • Conference paper (peer-reviewed)abstract
    • In the last couple of years, many e-Science infrastructures have begun to offer production services to e- Scientists with an increasing number of applications that require access to different kinds of computational resources. Within Europe two rather different multi-national e-Science infrastructures evolved over time namely Distributed European Infrastructure for Supercomputing Applications (DEISA) and Enabling Grids for E-SciencE (EGEE). DEISA provides access to massively parallel systems such as supercomputers that are well suited for scientific applications that require many interactions between their typically high numbers of CPUs. EGEE on the other hand provides access to a world-wide Grid of university clusters and PC pools that are well suited for farming applications that require less or even no interactions between the distributed CPUs. While DEISA uses the HPC-driven Grid technology UNICORE, EGEE is based on the gLite Grid middleware optimized for farming jobs. Both have less adoption of open standards and therefore both systems are technically non-interoperable, which means that no e-Scientist can easily leverage the DEISA and EGEE infrastructure with one suitable client environment for scientific applications. This paper argues that future interoperability of such large e-Science infrastructures is required to improve e-Science in general and to increase the real scientific impact of world-wide Grids in particular. We discuss the interoperability achieved by the OMII-Europe project that fundamentally improved the interoperability between UNICORE and gLite by using open standards. We also outline one specific scientific scenario of the WISDOM initiative that actually benefits from the recently established interoperability.
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14.
  • Memon, M. A., et al. (author)
  • Aetiology and associations of halitosis : A systematic review
  • 2023
  • In: Oral Diseases. - : Wiley. - 1354-523X .- 1601-0825. ; 29:4, s. 1432-1438
  • Research review (peer-reviewed)abstract
    • Halitosis is a term that refers to an unpleasant or foul odour originating from the oral cavity that can be caused by either intra-oral or extra-oral factors. Despite the fact that halitosis has multifactorial aetiology, intra-oral factors play a significant role in the majority of cases. This systematic review assesses halitosis's intra-oral and extra-oral associations. An electronic search through MEDLINE (PubMed), Google Scholar and the Wiley Online Library was conducted to identify relevant manuscripts. A keywords-based search was performed, using the terms ‘halitosis’, ‘bad-breath’, and ‘oral malodour causes and aetiology’. Articles published from January 2014 to December 2020 were included. We selected studies evaluating the intra-oral and extra-oral factors that induce oral malodour, as well as the factors associated with systemic diseases. Eighty to ninety percent of halitosis is caused by intra-oral factors, with coated tongue, periodontal diseases and poor oral hygiene practices being the principal factors. Ten to twenty percent of halitosis is induced by extra-oral factors associated with systemic diseases. Multiple factors can cause halitosis, but most of the aetiology is intra-oral. Increased medical awareness is needed to determine the actual pathophysiological process of oral malodour in otherwise healthy individuals. 
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15.
  • Hedman, Fredrik, et al. (author)
  • Benchmarking of Integrated OGSA-BES with the Grid Middleware
  • 2009
  • In: EURO-PAR 2008 WORKSHOPS - PARALLEL PROCESSING. - Berlin : Springer Berlin/Heidelberg. - 9783642009549 ; , s. 113-122
  • Conference paper (peer-reviewed)abstract
    • This paper evaluates the performance of the emerging OGF standard OGSA - Basic Execution Service (BES) on three fundamentally different Grid middleware platforms: UNICORE 5/6, Globus Toolkit 4 and gLite. The particular focus within this paper is on the OGSA-BES implementation of UNICORE 6. A comparison is made with baseline measurements, for UNICORE 6 and Globus Toolkit 4, using the legacy job submission interfaces. Our results show that the BES components are comparable in performance to existing legacy interfaces. We also have a strong indication that other factors, attributable to the supporting infrastructure, have a bigger impact on performance than BES components.
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16.
  • Memon, Maaz A., et al. (author)
  • Assessing salivary matrix metalloproteinase-8 in prostate cancer patients undergoing androgen deprivation therapy
  • 2022
  • In: Clinical and Experimental Dental Research. - : Wiley. - 2057-4347. ; 8:5, s. 1277-1283
  • Journal article (peer-reviewed)abstract
    • Introduction: Matrix metalloproteinase-8 (MMP-8) is considered as one of the most promising diagnostic markers for periodontal disease. Androgen deprivation therapy (ADT) has been correlated with impaired collagen synthesis and an increase in periodontal tissue susceptibility to pathogenic microorganisms. Objective: This study aims to investigate the impact of ADT on salivary MMP-8 level and periodontal parameters, which might be useful in monitoring periodontal disease in prostate cancer patients undergoing ADT. Materials and Methods: A total of 88 subjects were selected and were divided into two groups: Group I included n = 78 PC patients who have been undergoing ADT); Group II included n = 10 healthy individuals. Periodontal parameters such as plaque index (PI), gingival index (GI), periodontal probing depth (PPD), and clinical attachment level (CAL) were examined. The salivary MMP-8 level was estimated by using the sandwich enzyme-linked immunosorbent assay method. Results: Significant differences in mean salivary MMP-8 level were found between PC patients undergoing ADT and healthy individuals. Salivary MMP-8 levels of all individuals were positively correlated with GI, PI, PPD, and CAL. Salivary MMP-8 can distinguish between periodontitis and healthy individuals with an accuracy of about 80%. Conclusion: Salivary MMP-8 levels were found to be higher in prostate cancer patients undergoing ADT compared to healthy individuals. 
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17.
  • Marzolla, M., et al. (author)
  • Open standards-based interoperability of job submission and management interfaces across the grid middleware platforms gLite and UNICORE
  • 2007
  • In: Proceedings - e-Science 2007, 3rd IEEE International Conference on e-Science and Grid Computing. - : IEEE Computer Society. - 0769530648 - 9780769530642 ; , s. 592-599
  • Conference paper (peer-reviewed)abstract
    • In a distributed Grid environment with ambitious service demands the job submission and management interfaces provide functionality of major importance. Emerging e-Science and Grid infrastructures such as EGEE and DEISA rely on highly available services that are capable of managing scientific jobs. It is the adoption of emerging open standard interfaces which allows the distribution of Grid resources in such a way that their actual service implementation or Grid technologies are not isolated from each other, especially when these resources are deployed in different e-Science infrastructures that consist of different types of computational resources. This paper motivates the interoperability of these infrastructures and discusses solutions. We describe the adoption of various open standards that recently emerged from the Open Grid Forum (OGF) in the field of job submission and management by well-known Grid technologies, respectively gLite and UNICORE. This has a fundamental impact on the interoperability between these technologies and thus within the next generation e-Science infrastructures that rely on these technologies.
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18.
  • Agostini, Patrick, et al. (author)
  • Not-Too-Deep Channel Charting (N2D-CC)
  • 2022
  • In: 2022 IEEE Wireless Communications and Networking Conference (WCNC). - : IEEE. ; , s. 2160-2165
  • Conference paper (peer-reviewed)abstract
    • Channel charting (CC) is an emerging machine learning method for learning a lower-dimensional representation of channel state information (CSI) in multi-antenna systems while simultaneously preserving spatial relations between CSI samples. The driving objective of CC is to learn these representations or channel charts in a fully unsupervised manner, i.e., without the need for having access to explicit geographical information. Based on recent findings in deep manifold learning, this paper addresses the problem of CC via the "not-too-deep" (N2D) approach for deep manifold learning. According to the proposed approach, an embedding of the global channel chart is first learned using a deep neural network (DNN)-based autoencoder (AE), and this embedding is subsequently searched for the underlying manifold using shallow clustering methods. In this way we are able to counter the problem of collapsing extremities - a well known deficiency of channel charting methods, which in previous research efforts could only be mitigated by introducing side-information in form of distance constraints. To further exploit the ever-increasing spatio-temporal CSI resolution in modern multi-antenna systems, we propose to augment the employed AE with convolutional neural network (CNN) input layers. The resulting convolutional autoencoder (CAE) architecture is able to automatically extract sparsely distributed spatio-temporal features from beamspace domain CSI, yielding a reduced computational complexity of the resulting model.
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19.
  • Ahmad, Abrar, et al. (author)
  • Alpha 2-macroglobulin 5 bp insertion/deletion polymorphism increases the risk of recurrent venous thromboembolism
  • 2018
  • In: Gene Reports. - : Elsevier BV. - 2452-0144. ; 13, s. 104-109
  • Journal article (peer-reviewed)abstract
    • Alpha 2-macroglobulin (A2M) is a protease inhibitor that has been reported to neutralize thrombin, which may decrease the risk of thrombosis. A 5-base pairs (bp) insertion/deletion polymorphism (rs3832852) at the splice acceptor site of exon 18 has been shown to affect the binding of A2M with proteases. However, the role of this important variant in A2M in recurrent VTE is unknown. We investigated the role of 5 bp insertion/deletion polymorphism in VTE recurrence in a follow up study. A2M 5 bp insertion/deletion polymorphism was genotyped in Malmö Thrombophilia Study (MATS, n = 1465, with follow up of ~10 years) by TaqMan Allelic Discrimination assay. Univariate Cox regression analysis showed that A2M polymorphism was significantly associated with higher risk of VTE recurrence (hazard ratio [HR] = 2.61, 95% confidence interval [CI] = 1.06–6.45, P = 0.037). This association remained significant (HR = 2.61, 95% CI = 1.06–6.47, P = 0.038) even after adjusting for sex, family history of VTE, thrombophilia and acquired risk factors for VTE. In conclusion, our results indicate that patients with A2M 5 bp insertion/deletion polymorphism are at significantly higher risk of VTE recurrence and this may predict VTE recurrence.
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20.
  • Ahmad, Abrar, et al. (author)
  • Association between TLR9 rs5743836 polymorphism and risk of recurrent venous thromboembolism
  • 2017
  • In: Journal of Thrombosis and Thrombolysis. - : Springer Science and Business Media LLC. - 1573-742X .- 0929-5305. ; 44:1, s. 130-138
  • Journal article (peer-reviewed)abstract
    • Recent gene knockout studies on mice have shown the role of toll-like receptor 9 (TLR9) in resolution of venous thromboembolism (VTE) through sterile inflammation. However, the role of a putative functional TLR9 polymorphism (rs5743836) in risk assessment of VTE recurrence remains unknown. The aim of our study was to investigate the TLR9 rs5743836 polymorphism in VTE patients and its association with the risk of VTE recurrence. We analyzed TLR9 rs5743836 polymorphism in Malmö thrombophilia study patients; a prospective follow-up study of 1465 VTE patients by Taqman PCR. From a total of 1465 VTE patients, those who had VTE before inclusion and those who died or had VTE recurrence during anticoagulant treatment were excluded (n = 415). Cox regression analyses were performed on the remaining 1050 VTE patients, including 126 (12.5%) patients that had recurrent VTE during follow-up period. TLR9 polymorphism was significantly associated with higher risk of VTE recurrence in female patients (HR 3.46, 95% CI 1.06-11.33) independent of acquired risk factors for VTE, family history, risk of thrombophilia and deep vein thrombosis (DVT) location. Similarly, in unprovoked VTE patients, TLR9 polymorphism was significantly associated with higher risk of VTE recurrence in female patients (HR 5.94, 95% CI 1.25-28.13) after adjusting for family history, risk of thrombophilia and DVT location. No association between TLR9 polymorphism and risk of VTE recurrence was found in male patients. Our results suggest that TLR9 rs5743836 polymorphism is an independent risk factor for VTE recurrence in female patients but not in males.
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21.
  • Ahmad, Abrar, et al. (author)
  • Evaluation of Expression Level of Apolipoprotein M as a Diagnostic Marker for Primary Venous Thromboembolism
  • 2018
  • In: Clinical and Applied Thrombosis/Hemostasis. - : SAGE Publications. - 1938-2723 .- 1076-0296. ; 24:3, s. 416-422
  • Journal article (peer-reviewed)abstract
    • Recently, decreased levels of apolipoprotein M (ApoM) were shown to be associated with higher risk of recurrent venous thromboembolism (VTE) in male patients. However, the role of ApoM in primary VTE is unknown. We aimed in our study to analyze the plasma levels of ApoM in patients with VTE in order to evaluate the diagnostic importance of ApoM in primary VTE. A total of 357 patients with suspected first episode of VTE were recruited prospectively in the SCORE study. Plasma samples from 307 patients were available for quantifying the plasma levels of ApoM in patients with VTE using sandwich enzyme-linked immunosorbent assay method. Among the whole population, plasma levels (mean [standard deviation]) of ApoM were not significantly different between patients with VTE (0.72 [0.20]) and non-VTE patients (0.72 [0.16]), P = .99. Similarly, in regression analyses, no significant association of ApoM plasma levels with the risk of VTE was found on univariate (odds ratio [OR] =1.0, 95% confidence interval [CI] 0.21-4.84, P = .99) and multivariate analysis (OR = 1.25, 95% CI = 0.19-8.34, P = .819) after adjusting for age, body mass index, and smoking. Moreover, results did not differ significantly after stratification of data according to sex ( P > .05). In this study, our results do not suggest a diagnostic role for ApoM plasma levels in patients with primary VTE. Moreover, the current study suggests that role of ApoM as a risk factor may differ for primary VTE and recurrent VTE in male patients.
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22.
  • Ahmad, Abrar, et al. (author)
  • Fat mass and obesity-associated gene rs9939609 polymorphism is a potential biomarker of recurrent venous thromboembolism in male but not in female patients
  • 2018
  • In: Gene. - : Elsevier BV. - 0378-1119. ; 647, s. 136-142
  • Journal article (peer-reviewed)abstract
    • Multiple genetic variations have been identified in FTO (fat mass and obesity-associated) gene. Among them, FTO rs9939609 polymorphism is shown to be associated with the risk of primary venous thromboembolism (VTE). However, its role in recurrent VTE is not known. The aim of our study was to investigate the association between FTO rs9939609 polymorphism and the risk of VTE recurrence in a prospective follow-up study in both male and female patients. FTO rs9939609 polymorphism (T/A) was analyzed in the Malmö thrombophilia study (MATS, followed for ~10 years) by using TaqMan PCR. MATS patients (n = 1050) were followed from the discontinuation of anticoagulant treatment until diagnosis of VTE recurrence or the end of follow-up. A total of 126 patients (12%) had VTE recurrence during follow-up. Cox regression analyses showed that sex modified the potential effect of FTO rs9939609 polymorphism on VTE recurrence. Male patients with the AA genotype for the FTO rs9939609 polymorphism had significantly higher risk of VTE recurrence as compared to the TT or AT genotypes (univariate hazard ratio [HR] = 2.05, 95% confidence interval [CI] = 1.2-3.5, P = 0.009 and adjusted HR = 2.03, 95% CI 1.2-3.6, P = 0.013). There was no association between FTO rs9939609 polymorphism and VTE recurrence in female patients. In conclusion, our results show that FTO rs9939609 polymorphism in recurrent VTE may differ according to gender and FTO polymorphism may predict VTE recurrence in male patients.
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23.
  • Ahmad, Abrar, et al. (author)
  • Identification of Genetic Aberrations in Thrombomodulin Gene in Patients with Recurrent Venous Thromboembolism
  • 2017
  • In: Clinical and Applied Thrombosis/Hemostasis. - : SAGE Publications. - 1076-0296 .- 1938-2723. ; 23:4, s. 319-328
  • Journal article (peer-reviewed)abstract
    • Thrombomodulin (THBD) serves as a cofactor for thrombin-mediated activation of anticoagulant protein C pathway. Genetic aberrations in THBD have been studied in arterial and venous thrombosis. However, genetic changes in THBD and their role in the risk assessment of recurrent venous thromboembolism (VTE) are not well understood. The aim of the present study was to identify the genetic aberrations in THBD and their association with the risk of VTE recurrence in a prospective population-based study. We sequenced the entire THBD gene, first in selected patients with VTE (n = 95) by Sanger sequencing and later validated those polymorphisms with minor allele frequency (MAF) ≥5% in the whole study population (n = 1465 with the follow-up period of 1998-2008) by Taqman polymerase chain reaction. In total, we identified 8 polymorphisms in THBD, and 3 polymorphisms with MAF ≥5% were further validated. No significant association between THBD polymorphisms and risk of VTE recurrence on univariate or multivariate Cox regression analysis was found (hazard ratio [HR] = 0.89, 95% confidence interval [CI] = 0.62-1.28, HR = 1.27, 95% CI = 0.88-1.85, and HR = 1.15, 95% CI = 0.80-1.66 for THBD rs1962, rs1042580, and rs3176123 polymorphisms, respectively), adjusted for family history, acquired risk factors for VTE, location of deep vein thrombosis, and risk of thrombophilia. Subanalysis of patients with unprovoked first VTE also showed no significant association of identified THBD polymorphisms with the risk of VTE recurrence. Our results show that aberrations in the THBD gene may not be useful for the assessment of VTE recurrence; however, further studies with large sample size are needed to confirm these findings.
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24.
  • Ahmad, Abrar, et al. (author)
  • Identification of polymorphisms in Apolipoprotein M gene and their relationship with risk of recurrent venous thromboembolism
  • 2016
  • In: Thrombosis and Haemostasis. - 0340-6245. ; 116:3, s. 41-432
  • Journal article (peer-reviewed)abstract
    • Apolipoprotein M (ApoM) plasma levels have been reported to be associated with risk of venous thromboembolism (VTE) recurrence. However, the role of genetic alterations in the ApoM gene in VTE recurrence remains unknown. The aim of this study was to identify genetic aberrations in ApoM gene in VTE recurrence and their role in prediction of VTE recurrence in a prospective follow-up study of 1465 VTE patients. During follow-up, 156 (10.6 %) patients had VTE recurrence. First screening of whole ApoM gene was performed by Sanger's sequencing in selected age and sex matched non-recurrent and recurrent patients (n=95). In total six polymorphisms were identified and two polymorphisms (rs805297 and rs9404941) with minor allele frequency (MAF) ≥5 % were further genotyped in the whole cohort by Taqman PCR. ApoM rs805297 polymorphism was significantly associated with higher risk of VTE recurrence in males but not in females on both univariate (p= 0.038, hazard ratio = 1.72, confidence interval = 1.03-2.88) and on multivariate analysis adjusted with mild and severe thrombophilia, family history, location and acquired risk factors for VTE. However, ApoM rs9404941 polymorphism showed no significant association with risk of VTE recurrence in all patients as well as in different gender groups. Moreover, ApoM rs805297 and rs9404941 polymorphisms were not associated with the ApoM plasma levels. In conclusion, for the first time we have sequenced whole ApoM gene in VTE and identified six polymorphisms. ApoM rs805297 was significantly associated with higher risk of VTE recurrence in male but not in female patients.
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25.
  • Ahmad, Abrar, et al. (author)
  • Risk prediction of recurrent venous thromboembolism : a multiple genetic risk model
  • 2019
  • In: Journal of Thrombosis and Thrombolysis. - : Springer Science and Business Media LLC. - 0929-5305 .- 1573-742X. ; 47:2, s. 216-226
  • Journal article (peer-reviewed)abstract
    • A single genetic biomarker is unable to accurately predict the risk for venous thromboembolism (VTE) recurrence. We aimed to: (a) develop a multiple single nucleotide polymorphisms (SNPs) model to predict the risk of VTE recurrence and (b) validate a previously described genetic risk score (GRS) and compare its performance with the model developed in this study. Twenty-two SNPs, including established and putative SNPs associated with VTE risk, were genotyped in the Malmö thrombophilia study cohort (MATS; n = 1465, follow-up ~ 10 years) by using TaqMan PCR. Out of 22-SNPs, 12 had an association with the risk of VTE recurrence and were included for calculating GRSs. The risk of VTE recurrence was calculated by stratifying patients according to number of risk alleles. In 12-SNP GRS, patients with ≥ 7 risk alleles were associated with higher risk of VTE recurrence compared to patients having ≤ 6 risk alleles. In a simplified model (8-SNP GRS), the discriminative power of 8-SNP GRS was similar to that of 12-SNP GRS based on post-test probabilities (PP). Furthermore, 8-SNP GRS further improved the risk prediction of VTE recurrence in unprovoked VTE and male patients (PP% = 15.4 vs 8.3, 17.1 vs 7.2 and 19.0 vs 7.1 for high risk groups vs low risk groups in whole population, males and unprovoked VTE patients respectively). In addition, we also validated previously described 5-SNP GRS in our cohort and found that the 8-SNP GRS performed better than the 5-SNP GRS in terms of higher PP. Our results show that a multiple SNP GRS consisting of 8-SNPs may be an effective model for prediction of VTE recurrence, particularly in unprovoked VTE and male patients.
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