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The importance of biomarcers for estimation of joint damage in patients with hemophilia

dc.contributor.advisorElezović, Ivo
dc.contributor.otherSuvajdžić Vuković, Nada
dc.contributor.otherMihaljević, Biljana
dc.contributor.otherLešić, Aleksandar
dc.contributor.otherMiljić, Predrag
dc.creatorĐunić, Irena S.
dc.date.accessioned2016-01-05T12:07:33Z
dc.date.available2016-01-05T12:07:33Z
dc.date.available2020-07-03T08:55:06Z
dc.date.issued2014-04-02
dc.identifier.urihttp://eteze.bg.ac.rs/application/showtheses?thesesId=1997
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/2506
dc.identifier.urihttps://fedorabg.bg.ac.rs/fedora/get/o:9749/bdef:Content/download
dc.identifier.urihttp://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=46739727
dc.description.abstractHemofilna artropatija,, sa karakterističnim oštećenjima zglobova, vodeći je uzrok morbiditeta kod bolesnika sa teškom hemofilijom. Kontinuirana profilaksa intravenskom primenom primenom faktora (F) VIII i IX je glavna klinička strategija u lečenju ovih bolesnika. Nedavno je pokazano da se biomarkeri razgradnje zglobne hrskavice mogu detektovati u serumu iili urinu i odražavaju stepen ukupnog oštećenja zglobova kod bolesnika sa hemofilijom. Ciljevi ove studije bili su: a) uporediti validnost dva laboratorijska testa – rotaciona tromboelastometrija (ROTEM) i potencijal endogenog trombina (ETP) u praćenju efikasnosti dva različita profilaktička režima lečenja bolesnika sa teškom hemofilijom; b) odrediti korelaciju između koncentracije biomarkera degradacije zglobne hrskavice u serumu i urinu i radiološkog skora za hemofilnu artropatiju; c) proceniti da li određivannje koncentracije ovih biomarkera može biti korisna u praćenju efikasnosti različitih režima profilakse teške hemofilije. Ova studija obuhvatila je 20 odraslih bolesnika sa teškom hemofilijom. Pet bolesnika sa hemofilijom A primalo je profilaksu koncentratom FVIII u standardnoj dozi od 20 i.j./kg tri puta nedeljno, pet bolesnika sa hemofilijom A primalo je kao profilaksu intermedijarne doze koncentrata FVIII, 10-15 i.j./kg tri puta nedeljno. Sedam bolesnika sa hemofilijom A i tri bolesnika sa hemofilijom B primalo je koncentrat FVIII/IX samo po potrebi (“on demand). Kod bolesnika na profilaktičkoj terapiji, ROTEM i ETP određivani su inicijalno pre početka profilakse, zatim, 20 minuta nakon primene prve doze profilakse i posle tri meseca, pre primene sledeće profilaktičke doze. Kod bolesnika na “on demand” terapiji, ROTEM i ETP rađeni su dva puta u intervalu od tri meseca. U ROTEM testu određivano je vreme koagulacije (CT) unutrašnjeg puta (INTEM), dok je kod ETP određivana kalkulisana vrednost površine ispod krive generacije trombina (ETP.AUC.cal) i kalkulisane vrednosti maksimalne koagulacije (ETP.Cmax.cal)...sr
dc.description.abstractHaemophilic arthropathy, with characteristic joint damage, is the main cause of morbidity in individuals with severe haemophilia. The most important clinical strategy for management of these patients is treatment by continous prophylaxis with intravenously applied factor (F) VIII/IX. Recently, it was shown that serum and/or urine biomarkers of cartilage turnover in joints reflected the degree of total joint degradation in haemophilia patients. The aims of this study were: a) to compare validity of two laboratory assays – rotating thromboelastometry (ROTEM) and endogenous thrombin potential (ETP) in monitoring and evaluating different prophylactic treatment regimens in patients with severe haemophilia; b) to detect correlations between serum and urine concentrations of biomarkers of joint cartilage degradation and the radiological score for haemophilic arthropathy and c) to estimate whether measurement of these biomarkers could be useful in monitoring the efficacy of different prophylaxis regimens for severe haemophilia. This study included 20 adults patients with severe haemophilia, without inhibitor. Five patients with haemophilia A were received prophylaxis with factor VIII (FVIII) concentrate in standard dose 20 IU/kg three times per week, five patients with haemophilia A were received intermediate dose of FVIII concentrate as prophylaxis, 10- 15 IU/kg three times per week. Seven patients with haemophilia A and 3 with haemophilia B, were received FVIII/IX concentrate only on-demand. In patients on prophylactic therapy, ROTEM and ETP were done initially before start of prophylaxis, in addition, 20 minutes after application of first prophylactic dose and afterwards 3 months, before receiving next prophylactic dose. In patients treated only on-demand, ROTEM and ETP were done twice per three-months period. In ROTEM, clotting time (CT) in intrinsic system (INTEM) was measured, whereas in ETP,calculated values of area under the thrombin generation curve (ETP.AUC2.cal) and calculated values of maximal clotting (ETP.Cmax.cal) were estimated...en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Београду, Медицински факултетsr
dc.rightsopenAccessen
dc.sourceУниверзитет у Београдуsr
dc.subjecthemofilijasr
dc.subjecthaemophiliaen
dc.subjecthemofilna artropatijasr
dc.subjectprofilaksasr
dc.subjecttestovi hemostazesr
dc.subjectbiomarkeri zglobne hrskavicesr
dc.subjecthaemophilic arthropathyen
dc.subjectprophylaxisen
dc.subjecthaemostatic testsen
dc.subjectbiomarkers of joint cartilageen
dc.titleZnačaj biomarkera u proceni oštećenja zgloba kod bolesnika sa hemofilijomsr
dc.titleThe importance of biomarcers for estimation of joint damage in patients with hemophiliaen
dc.typedoctoralThesis
dc.rights.licenseBY
dcterms.abstractЕлезовић, Иво; Лешић, Aлександар; Михаљевић, Биљана; Сувајджић Вуковић, Нада; Миљић, Предраг; Ђунић, Ирена С.; Значај биомаркера у процени оштећења зглоба код болесника са хемофилијом; Значај биомаркера у процени оштећења зглоба код болесника са хемофилијом;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/11386/Disertacija.pdf


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