Background Deep vein thrombosis (DVT) is a common complication and the second leading cause of death in cancer patients. Pro-inflammatory stimuli in the cancer microenvironment induce nuclear factor kappa B (NF-κB) signaling pathway that plays an integral role in immunothrombosis mechanism. Objective To investigate the role of inflammatory and coagulation biomarkers in the development of DVT in cancer patients with high risk of thrombosis (Khorana score ≥2). Subjects and methods This study was a cross-sectional study at Dr. Kariadi General Hospital. The serum levels of proinflammatory cytokines, ie, NF-κB, interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and coagulation biomarkers, ie, tissue factor (TF), prothrombin fragment F1+2 (F1+2), fibrinogen and D-dimer were measured in newlydiagnosed cancer patients with a highrisk of thrombosis. Color duplex sonography was used for DVT screening. Results From January to November 2021, there were 83 eligible patients. DVT was confirmed in 8 subjects (9.63%). Univariate analysis revealed a significant difference between the median age of patients with DVT compared to non-DVT patients, 49.5 years (range: 23–60 years) and 42 years (range: 19–60 years), with p=0.046. D-dimer level was higher in DVT patients [(6.020 µg/L, range 2.090–20.000) vs (1.940 µg/L, range 270–20.000), p=0.005]. Multivariate analysis revealed age and D-dimer were significantly correlated with DVT incidence. In all patients, there were significant positive correlations between several inflammatory and coagulation activation parameters, which were IL-6 with D-dimer and F1+2, CRP with F1+2 and D-dimer as well as TNF-α with F1+2. However, these findings were not shown in DVT patients. Conclusion In cancer patients with a high risk of thrombosis, age and D-dimer level are the significant variables towards the incidence of DVT. In patients with DVT, there was no significant correlation between inflammatory and coagulation activation parameters.

BACKGROUND: The mutation spectrums of hemoglobinopathy are different among populations that yield a different result of erythrocyte indices. Calculation of erythrocyte indices with some formula has been reported to differentiate between hemoglobinopathy and non-hemoglobinopathy, but its cut-off should be recalculated specific for each population to gain a better sensitivity and specificity. We aimed to evaluate red blood cell count (RBC), Mentzer index, red cell distribution width (RDW), RDW index (RDWI), Shine and Lal index (S&L) and Green and King index (G&K) to screen hemoglobinopathy in Indonesia.METHODS: A retrospective cross-sectional study was performed on 202 subjects. The diagnosis of hemoglobinopathy was determined based on the results of complete blood count (CBC) data, high-performance liquid chromatography (HPLC) and Hemoglobin H (HbH) inclusion body. The ferritin concentration was checked to determine the status of iron. The erythrocytes indices were analyzed and calculated to predict hemoglobinopathy. RESULTS: A total 202 subjects who met the criteria were involved in this study. Fifty percent showed pure hemoglobinopathy and 4% showed a combination of thalassemia and hemoglobinopathy. The hemoglobin concentration and RBC were significantly higher, and the mean corpuscular volume (MCV) and RDW were significantly lower in hemoglobinopathy compared to iron deficiency. The difference was not significant if the hemoglobinopathy was combined with iron deficiency. By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity.CONCLUSION: The new cut-off of erythrocyte index and its calculation to screen hemoglobinopathy in Indonesia showed a higher sensitivity and specificity, especially for G&K and RDWI with cut-off 73 and 228, respectively. The presence of iron deficiency in hemoglobinopathy could decrease the sensitivity.KEYWORDS: hemoglobinopathy, RBC, Mentzer index, RDW, RDWI, S&L, G&K

AbstrakTujuan Kadar plasminogen activator inhibitor-1 Hasil Kadar PAI-1 yang tinggi ditemukan lebih sering pada penderita stroke iskemik daripada subjek kontrol (21.1% vs. 7.9 % dengan OR 3.1;. Analisa terhadap semua subjek yang diteliti menunjukkan adanya hubungan negatif yang lemah namun bermakna antara kadar PAI-1 dengan usia (r = -0.4; P = 0.000). Kadar PAI-1 yang tinggi ditemukan lebih sering pada subjek berusia muda (40 -58 tahun) daripada subjek berusia lebih tua ( 60 -84 tahun) (20 vs. 9 .8 %) (P = 0.004). Kesimpulan Dari hasil penelitian pendahuluan ini diduga ada hubungan antara kadar PAI-1 dengan stroke iskemik pada usia muda. Penelitan lebih lanjut dengan jumlah subjek yang lebih besar diperlukan untuk memastikan keadaan ini. (Med J Indones 2010; 19:158-63) AbstractAim Recently, increased plasminogen activator inhibitor-1 (PAI-1) has been known a risk factor for ischemic heart disease. However, the association of increased PAI-1 level with ischemic stroke remains unclear. The aim of this study was to analyze the association of PAI-1 level with ischemic stroke.Methods By case control design we involved 38 ischemic stroke and 38 risky-matched control subjects who fulfilled the criteria. The PAI-1 level was determined by ELISA method using Asserachrom PAI-1 from Stago. ResultsHigh PAI-1 level was found more frequent in ischemic stroke subjects than in control subjects (21.1% vs. 7.9 % with OR 3.1; 95 % CI 0.757 -12.790). The analysis of all studied subjects showed that there was a weak negative correlation between PAI-1 level and age (r = -0.4; P = 0.000). High PAI-1 level was found more frequent in younger (40 -58 years old) than in the older subjects (60 -84 years old) (20% vs. 9.8 %) (p=0.004). ConclusionThe result of this preliminary study suggested an association between PAI-1 level and ischemic stroke in younger age. Further study with larger subjects is recommended to confirm this association. Stroke is the second most common cause of death in the world, with almost 5.1 million people died annually due to stroke. In an attempt for stroke prevention, stroke risk factors should be recognized and controlled.1 In the last decade several conditions associated with stroke Have revealed that plasminogen activator inhibitor-1 (PAI-1) was suspected to play a role in stroke incidence. 2Plasminogen activator inhibitor-1 is the main physiologic regulator in fibrinolytic system since it can inhibit the activity of plasminogen activator. Increased PAI-1 level results in decreased fibrinolytic activity and, therefore, increases the risk of thrombosis.2 It was reported that PAI-1 may influence the progression of atherosclerosis. Increased PAI-1 level causes atherosclerotic lesion susceptible to thrombotic complication. [3][4][5][6] Increased PAI-1 level has been found in some myocardial infarct cases. 7 The risk for myocardial infarction is 3.35 times higher in subjects with high level of PAI-1 compared to those with the normal level of PAI-1. 8 The properties of vasculature in the heart and brain are diff...

Thromboembolic events and hypercoagulable state have been reported in patients with thalassemia. As platelets play an important role in the pathogenesis of thrombosis, the authors aimed to find the pattern of changes in platelet count, function and activation, and evidence of coagulation activation in patients with thalassemia major in Indonesia. A total of 31 patients with splenectomized and 35 patients with nonsplenectomized thalassemia major were enrolled in this study. Platelet count, platelet aggregation, beta-thromboglobulin, and D-dimer levels were measured. All measured parameters were significantly higher in splenectomized than in nonsplenectomized patients. beta-thromboglobulin level was increased, but D-dimer level was within normal range. The authors concluded that there was an increase in platelet activation in patients with beta-thalassemia major. Platelet activation was higher in splenectomized than in nonsplenectomized patients.