D -dimer threshold of 1100 μg/L remains valid. However, among the patients who did not undergo CTPA, some patients might have asymptomatic PE. In addition, some outpatients might be diagnosed with PE at other hospi- tals, although we instructed them to visit our hospital again when they had symptoms of PE. Therefore, multi- center and multi-national prospective studies will be needed. Third, although all eligible patients underwent CTPA in the initial evaluation in the ED, they did not necessarily undergo follow-up within a definitive period, such as 3 months. A previous study reported that the sensitivity of multidetector CTPA was 83% . This result may indicate that CTPA alone may miss PE. How- ever, in patients with low or intermediate clinical prob- ability and a negative multidirector CTPA result during initial evaluation, the 3-month risk of PE was low (1.5%, 95% CI 0.8–3.0) . Because the probability of PE in the eligible patients in our study was low or intermedi- ate, this limitation might be addressed.
Methods: Upon admission, we measured 343 AECOPD patients’ serum D-dimer levels and arterial blood gas analysis, and recorded their clinical characteristics. The level of D-dimer that discriminated survivors and non-survivors was determined using a receiver operator curve (ROC). The risk factors for in-hospital mortality were identified through univariate analysis and multiple logistic regression analyses. To evaluate the predictive role of D-dimer for 1-year mortality, univariate and multivariate Cox regression analyses were performed.
The search was done based on preferred reporting system for meta-analysis and systemic review (PRISMA) guideline. All the scientific database like Pubmed central, NIH, NCBI, embrase, mediline, Cochrane and google scholar were used to research articles with keywords: ‘d- dimer, ‘SARS-CoV2’, ’severe cases’. All the published peer reviewed articles till date 17 th June 2020 were
A qualified phlebotomist drew 5 mL of whole blood, using a disposable syringe, through a venipuncture procedure. About 2.5 mL of the blood was transferred into a tube containing sodium citrate anticoagulant solution. This was mixed on the roller mixer machine and centrifuged for 15 minutes at 1500 g. The plasma was collected at the end of centrifugation and used for the D-dimer assay, prothrombin time (PT), and activated partial thromboplastin time (aPTT). The remaining 2.5 mL was transferred into a tube containing dipotassium ethylene diamine tetra- acetic acid and used for the determination of packed cell volume (PCV), platelets, and hemoglobin. All samples for the D-dimer assay were achieved at − 20 ° C until they were analyzed using the enzyme linked immunosorbent assay (ELISA) procedures.
Contraceptives are intentional prevention of conception through the use of various devices sexual practices, chemicals, drugs or surgical procedures become a contraceptive if its purpose is to prevent a woman from becoming pregnant. This is a cross sectional study conducted at ALnow Hospital Khartoum, Sudan, the study aimed to estimate D.dimer levels among Sudanese women take contraceptive pill. 50 Women uses contraceptive pill used as a cases and 50 apparently health women were used as a control. Three ml of venous blood samples were collected from each subject in 3.8% tri-sodium citrate (9:1 vol/vol) for D-dimer analysis. The study revealed that was clearly significant increase in D.dimer in women take oral contraceptive pill (p.value 0.000), also the study concluded that D-dimer level was increased in users oral contraceptive Sudanese women, that is increase the coagubility of the blood and might be become as a risk factor.
Up to our knowledge, this study is the first to investigate the quantitative D -dimer serum level in IIH patients and to study the role of anticoagulant therapy in IIH cases. The results obtained prove the possibility of an unrecognized non-occlusive venous cerebral thrombus impeding the CSF drainage as described in previous studies [3, 4]. We can assume that the anticoagulant therapy disrupted these microthrombi and improved the CSF drainage which was manifested by the improvement of the papilledema, visual field, visual acuity, and the VEPs results.
From our study, we compared the diagnostic effi- ciency of serum D-dimer with CRP and ESR for PJI diagnosis. The sensitivity and specificity of D-dimer fall between the sensitivity and specificity of serum CRP and ESR through the evaluation of 80 patients suspected of PJI. In a prospective study conducted by Shahi et al. , they reported that serum D-dimer outperformed both ESR and serum CRP, with a sen- sitivity of 89.5% and specificity of 92.8%. They also believed that “ elevated ” D-dimer at the time of reim- plantation could predict the infection, which caused subsequent failure. While for those false-positive results, they considered it as the infection caused by slow-growing organisms that did not elicit physio- logical inflammation and failed to meet the MSIS criteria for PJI. In another study conducted by Lee et al. , D-dimer was proved as effective in early de- tection of PJI if combined with levels of ESR and CRP. However, this study used the data of primary surgery and did not further compare the difference
This study is a single-center observational retrospective analysis that evaluated simple laboratory parameters as predictors of SAP. Here, we studied the diagnostic value of D-dimer levels for predicting AP severity. Many indicators are currently available for predicting SAP and include C-reactive protein (CRP) and BUN, the most widely used parameters for the assessment of AP sever- ity; however, none of them differ significantly within 24 h after the onset of symptoms. Levels of serum lipase and amylase, two major markers for pancreatitis, have also been shown to be disproportionate to the severity of the disease . Thus, these indicators seem to have reached their maximal efficacy [2, 8, 13, 14, 29, 30]. New indicators for assessing the severity of AP have been reported in recent studies [28, 31–33]. However, these detection indicators are expensive and difficult to oper- ate. In particular, the specific mechanism remains uncer- tain, and additional studies are needed. Interleukin-6 significantly improves the predictive value for severe acute pancreatitis but is difficult to detect . With the advent of a fully automated assay, IL-6 is currently being used clinically in some hospitals . Therefore, continuing to study valuable markers is necessary. The D-dimer level, which is a marker of the activation of coagulation and fibrinolysis, provides a rapid assessment of thrombotic activity and safely excludes patients with suspected venous thromboembolism (VTE) based on the clinical decision rule [36, 37]. In addition, D-dimer has been widely used in clinical settings because it is convenient and stable.
Background: The association between pulmonary tuberculosis and a hyper- coagulable state is well documented. An increased D-dimer level is linked with increasing the mortality of pulmonary tuberculosis infection. Objective: The current study aimed to the estimation and assessment of the D-dimer levels in Sudanese patients with pulmonary tuberculosis. Material and Methods: This is a case control study that was conducted during March 2016 at Faculty of Medical Laboratory Sciences, Alneelain University, Khartoum, Sudan. A total of 70 subjects were included in this study, classified into two groups. The first group consists of 40 subjects, among which 30 (75%) were males and 10 (25%) were female; their mean age is 32.3 years classified as patients group; of other 30 normal healthy subjects, 15 (50%) were female and 15 (50%) were males; their mean age was 33.1 years in the second group as normal control group. The platelet poor plasma was prepared immediately from citrated blood by centrifuging at 2000 rpm for 15 minutes. The data were collected by struc- tured interview and questionnaire, and then analyzed by using a computer program statistical package for social sciences (SPSS) version 21. The D-dimer levels were measured using immunometric assay (Nyco Card READER II). Result: The present study found that the D-dimer levels were statistically sig- nificantly higher in pulmonary tuberculosis patients compared to the normal healthy control groups (Mean ± SD 0.82 ± 0.54 vs. 0.33 ± 0.13 with p value 0.00). Conclusion: This study showed that Sudanese patient with pulmonary tuberculosis has increased the plasma D-dimer level, and this abnormality could be prone to Deep Vein Thrombosis (DVT).
Four different types of d-dimer assay formats are cur- rently available: enzyme linked immunosorbent assay (ELISA), whole blood erythrocyte agglutination assay (SimpliRED), semiquantitative latex agglutination assays (Accuclot, Trinity Biotech, Bray) and immunochromato- graphic/quantitative immunoturbidimetric assays. ELISA is considered the gold standard for the determination of d-dimer concentration. It is a highly sensitive test but is time consuming and not suitable for individual patient testing. The Accuclot d-dimer assay is less sensitive, but Table 3 The main findings of 405 CTPAs performed between 01/06/2008 and 31/07/2009 that met inclusion criteria
Patients and methods: Between June 2010 and December 2015, 118 HCC patients were admitted to Cannizzaro Hospital, Catania, and 50 controls were recruited from their relatives for health examinations. All enrolled patients were diagnosed and pathologically confirmed as having HCC. D-dimer was measured with an enzyme-linked immunosorbent assay using 2 monoclonal antibodies against nonoverlapping determinants of D-dimer.
The purpose of the study was to compare D - dimer levels in patients with benign and malignant tumors of uterus, cervix and ovary. The study indicated that plasma levels of D-dimer increased in malignant tumors. The mean level of D-dimer was significantly higher in malignant cervical tumors than uterine and ovarian tumors. Also, in all types of uterine, cervical and ovarian cancers, the level of D-dimer in advanced stages was significantly higher than the lower stages. In present study, D-dimer which shows the activity of fibrinolytic system in coagulation process was used as a marker to evaluate the relationship between abnormal coagulation/fibrinolysis and progression of gynecologic cancers. Several tumors are investigated about the level of D-dimers and their prognosis. Most tumors that have been studied are lung, 17 colon, 18 prostate 19 and breast 20 tumors and this is probably because of their higher prevalence
combined with other traditional indicators such as C-reactive protein, interleukin-6, and acute physiology and chronic health evaluation II is more effective at diagnosing sepsis [10-12]. D-dimer (DD) is an indicator of coagulation function. Studies have shown that coagulati- on dysfunction often exists in sepsis patients, especially in septic shock patients, indicating that it is related to the severity and prognosis of sepsis . There are few clinical studies that combine these two indicators for the diagnosis and prognosis of sepsis. This study prospec- tively studied the levels of PCT and DD in sepsis patients along with the severity and prognosis of sepsis, in order to evaluate the value of PCT and DD in evaluating sepsis severity and pro- gnosis.
D-dimers are not normally present in human blood plasma, except when the coagulation system has been activated, for instance because of the presence of thrombosis or disseminated intravascular coagulation. The D-dimer assay depends on the binding of a monoclonal antibody to a particular epitope on the D-dimer fragment. Several detection kits are commercially available; all of them rely on a different monoclonal antibody against D-dimer. Of some of these it is known to which area on the D-dimer the antibody binds. The binding of the antibody is then measured quantitatively by one of various laboratory methods.
PJI  stated serum CRP and ESR should always be per- formed in patients with suspected PJI, but low CRP and ESR cannot rule out PJI, the meaning of various new sero- logical markers has also been checked in PJI diagnosis [5– 13]. One of these tested serological markers, D-Dimer, which was traditionally used for venous thromboembol- ism (VTE) detecting, recently has been demonstrated as a promising marker and to perform better than CRP and ESR in PJI diagnosis [12, 13]. However, in this study, we found that D-Dimer does not perform better than CRP and ESR in PJI diagnosis. From our own perspective, the underlying reasons may be as follows: (1) D-Dimers are fi- brin degradation products formed due to fibrin clot dissol- ution by plasmin. Elevated D-Dimer not only be observed in deep vein thrombosis or pulmonary embolism, but also in inflammation, surgery, cancer, infection, injuries, hem- orrhages, and many others . So, in theory, it is not a specific marker for the distinction between PJI and aseptic loosening. (2) Although D-Dimer has been demonstrated to rise in septic arthritis, Ribera et al.  showed that it is synovial D-Dimer other than serum D-Dimer which is ele- vated in vivo study of foals with septic arthritis. (3) In Yong et al.’s paper , they emphasized that D-Dimer’s role is only effective in early (less than 6 weeks after oper- ation) PJI diagnosis with the combination of the ESR and CRP. However, in our study, the interval between previous
performed ROC curve analysis (Figure 1). The areas under the curve (AUC) were 0.437 for local recurrence, 0.712 for metastasis and 0.749 for total survival, suggest- ing that there was no evident difference in the levels of d- dimer in patients with and without local recurrences; hence, local recurrence was deleted from the endpoints of this study. The optimal cut off value of d-dimer was determined at the point on ROC curve at which (sensitiv- ity+specificity-1) was maximized (Youden index). For metastasis, optimal cut off value of d-dimer was 0.41 μ g/ ml with which sensitivity and specificity were 0.83 and 0.57, respectively. In a similar way for total survival, opti- mal cut off value of d-dimer was 0.80 μg/ml with which sensitivity and specificity were 0.80 and 0.75, respectively. Next, the effect of independent variables, including d- dimer levels, on the 2 endpoints, namely, metastasis and total survival, was analyzed by using survival analysis model. The result of univariate analysis suggested that elevated d-dimer levels (p = 0.002) (Figure 2A) and his- tological grade (p = 0.009) were the significant risk fac- tors for metastases (Table 2); further, elevated d-dimer levels (p = 0.0004) (Figure 2B), histological grade (p = 0.03), and extracompartmental extension of the tumor (p = 0.04) were the significant risk factors for lethal out- come (Table 3). Multivariate analysis results suggested that both elevated d-dimer levels (p = 0.003) and histo- logical grade (p = 0.01) were the independent risk fac- tors for metastases, and elevated d-dimer levels (p = 0.004) and extracompartmental extension of the tumor (p = 0.04) were the independent risk factors for lethal outcome.
The area under the curve for the Geneva score was 0.659 (bootstrap 95% Cl, 0.558–0.759). The optimum diagnos- tic cut-off point maximizing sensitivity and specificity was found to be 5 points, with a sensitivity of 73.6% and a specificity of 51.2%, respectively. The corresponding PPV and NPV levels were 75.3% and 48.9%, respectively. Based on the cut-off values determined, biochemical markers and clinical probability scores were subsequently combined. Using a positive s-CTPA as the standard for diagnosis of PE, the diagnostic accuracy levels of the IMA, D-dimer, Well's score, Geneva score, Well's score + IMA, Geneva score + IMA, Well's score + D-dimer, Geneva score + D-dimer are shown in Table 4.
DDimer has a strong relationship with the MRV findings . in our study, all the DDimer positive patients had features of CVT in MRI. The association between DDimer and MRI is statistically significant in our study. This study implies that though MRI / MRV is the diagnostic modality for CVT, the presence of DDimer positivity can be taken as positive sign of CVT .Negative DDimer assay excludes the presence of thrombosis with a high certainity and MRI / MRV should be preferably used only in patients with positive DDimer test and highly suspected cases.
What role do the severity of the pain and the frequency of BPC have to play in determining the D-Ddimer level at a given time? The precise level of D-Ddimer circulating in the blood at a given time depends on the time elapsed since the thrombotic event, the initial size of the clot, and the rate of fibrinolysis. It is possible that the marked increase in D-Ddimer levels observed in this study was due to multiple sites with varying severity of thrombi formation during BPCs in patients with HbSS. D-Ddimer has a half-life of approximately 6 hours in the circulation of individuals with normal renal function. Patients with stabilized clots and who are not undergoing active fibrin deposition and plasmin activation may not have detectable D-Ddimer elevations. Determining D-Ddimer reflects activation of prothrombin plasminogen and of factor XIII. Thus, a direct test for circulating thrombin activity might give a clearer answer to the question of how severe the real state of coagulation activation is. 17
Abstract: Objective: The aim of this study was to investigate changes in levels of plasma D-dimer (D-D) in rheuma- toid arthritis (RA) patients and analyze its relationship with inflammatory factors interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Methods: Plasma levels of D-D, in 138 RA patients and 100 healthy controls, were determined and its correlation with age, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), IL-1, IL-6, and TNF-α were evaluated. RA patients in the observation group were divided into 3 subgroups based on RA disease activity score 28 (DAS28). There were 52 cases in group A (DAS28>5.1), 42 cases in group B (3.2<DAS28≤5.1), and 44 cases in group C (1.6<DAS28≤3.2). Results: Plasma D-D levels in the RA group were significantly higher than those of healthy control groups (P<0.01). In addition, plasma levels of D-D in groups A and B were significantly higher compared to those in group C (both P<0.01). Moreover, in all RA patients, D-D levels had a significantly positive correlation with age, ESR, RF, C-reactive protein, IL-1, IL-6, and TNF-α (all P<0.01). Conclusion: D-D can be used as a nonspecific inflammatory response index for clinical diagnosis of RA and as a guide for clinical treatment of this disease.