The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Prince Cangrande\u2019s Collagen: Study of Protein Modification on the Mummy of the Lord of Verona, Italy (1291\u20131329 AD)

The natural mummy of prince Cangrande, Lord of Verona, Italy (1291\u20131329 AD) was studied. Two samples were taken: rib bone and muscle. These samples were cleaved with trypsin and analysed by liquid chromatographic methods coupled to mass spectrometry (Q-TOF,ion-trap). Special attention was devoted to nonenzymatic protein modification\u2013\u2013the deamidation of asparagine and glutamine. A huge amount of collagen was determined in the tissues of the mummy (covering over 80 % of the sequence)\u2013\u2013collagen type I was identified in the rib bone and collagen types I and III in the muscle. A high overallpercentage of asparaginyl and glutaminyl residues were deamidated (up to 92 %). In agreement with the literature we can suppose that the deamidation of really old samples (at least 100-years-old) is mainly dependent on the burial conditions and/or thermal age and cannot serve as a precise \u201cmolecular clock\u201d