A bone implant should integrate to the tissue through a bone-like mineralized interface, which requires increased osteoblast activity at the implant-tissue boundary. Modification of the implant surface with synthetic bioinstructive cues facilitates on-site differentiation of progenitor stem cells to functional mature osteoblasts and results in subsequent mineralization. Inspired by the bioactive domains of the bone extracellular matrix proteins and the mussel adhesive proteins, we synthesized peptide nanofibers to promote bone-like mineralization on the implant surface. Nanofibers functionalized with osteoinductive collagen I derived Asp-Gly-Glu-Ala (DGEA) peptide sequence provide an advantage in initial adhesion, spreading, and early commitment to osteogenic differentiation for mesenchymal stem cells (hMSCs). In this study, we demonstrated that this early osteogenic commitment, however, does not necessarily guarantee a priority for maturation into functional osteoblasts. Similar to natural biological cascades, early commitment should be further supported with additional signals to provide a long-term effect on differentiation. Here, we showed that peptide nanofibers functionalized with Glu-Glu-Glu (EEE) sequence enhanced mineralization abilities due to osteoinductive properties for late-stage differentiation of hMSCs. Mussel-inspired functionalization not only enables robust immobilization on metal surfaces, but also improves bone-like mineralization under physiologically simulated conditions. The multifunctional osteoinductive peptide nanofiber biointerfaces presented here facilitate osseointegration for long-term clinical stability.

Increased TPO levels may increase both platelet count and platelet size, resulting in more hemostatic tendency, which may contribute to the progression of ischemic stroke.

Ankaferd is a folkloric medicinal plant extract which has historically been used as an hemostatic agent in traditional Turkish medicine. Ankaferd Hemostat (ABS, Ankaferd BloodStopper®) includes the plants of Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum and Urtica dioica. The hemostatic effects of ABS have been established in the in vitro and in vivo studies in the Literature. The basic mechanism of action for ABS is the formation of an encapsulated protein network representing the focal points for the vital erythroid aggregation. The topical usage of ABS as a hemostatic agent in clinical hemorrhages and during dental interventions provided the first clues about the safety and efficacy of ABS in humans. The aim of this study is to search topical safety of ABS in a phase I randomized, double-blinded, cross-over, placebo controlled clinical study in healthy volunteers. Twenty-four healthy volunteers (11 males and 13 females, aged 18-44 years) compatible with the study protocol were enrolled into the study. In this study, topical ABS application for 120 minutes is not different from the placebo, in terms of both the local skin findings and systemic laboratory tests. Based on those data, it is concluded that topical application of ABS is safe and tolerable in humans.Keywords: Ankaferd, Bleeding, Hemostasis, Hemorrhagic diathesis, Phase I trial ÖZET Topikal Ankaferd Hemostat'›n Güvenilirli¤ini Yans›tan Sa¤l›kl› Gönüllülerde Yap›lm›fl Plasebo Kontrollü, Randomize, Çift Kör, Çapraz Geçiflli Faz-I Klinik Çal›flmaAnkaferd, geleneksel Türk t›bb›nda hemostatik ajan olarak kullan›lan bir bitkisel bilefliktir. Ankaferd Hemostat (ABS, Ankaferd BloodStopper®) Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum ve Urtica dioica bitkileri ABS içeri¤inde yer almaktad›r. ABS hemostatik etkileri, literatürde in vitro ve in vivo çal›flmalarda gösterilmifltir. ABS'nin temel etki mekanizmas›, canl› eritroid aggregasyon için fokal odaklar teflkil eden bir protein a¤›n›n oluflturulmas›na dayanmaktad›r. Topikal ABS'nin insanlarda bir hemostatik ajan olarak etkinlik ve güvenilirlili¤ine iliflkin ilk bulgular, klinik kanamalar ve dental giriflimlerdeki ABS kullan›m verilerine dayanmaktad›r. Bu çal›flman›n amac›; randomize, çift-kör, çapraz geçiflli, plasebo-kontrollü, bir çal›flma ile sa¤l›kl› gönüllülerde topikal ABS'nin güvenilirlili¤ini araflt›rmakt›r. Yirmi dört sa¤l›kl› gönüllü (11 erkek ve 13 kad›n, 18-44 yafllar›nda) çal›flma protokolü ile uyumlu olarak çal›flmaya al›nm›fllard›r. Çal›flma sonuçlar›na göre 120 dakikal›k topikal ABS uygulamas› lokal cilt etkileri ve sistemik laboratuvar testleri yönünden plasebo uygulamas›ndan farks›z sonuçlar vermifltir. Bu verilere dayanarak insanlarda topikal ABS uygulamas›n›n güvenilir oldu¤u sonucuna var›lm›flt›r.

The widespread usage of blood count autoanalyzers has led to a major improvement in cellular hematology because of quick and accurate results found in most instances. However, spurious test results also can be observed like pseudothrombocytopenia (PTCP). In our study, we aimed to evaluate the clinical and laboratory factors associated with PTCP. Forty-six patients with PTCP and 69 healthy volunteers were enrolled in the study. Sex distribution was similar between the groups. Hospitalization, infection, the use of low-molecular-weight heparin and pregnancy increased the incidence of PTCP. Atherosclerosis and some drugs such as warfarin and calcium channel blockers were associated with PTCP, but the coincidence was not statistically significant. Antinuclear antibody positivity was higher in PTCP group (18.8% vs 7.2%; P=0.033) but anticardiolipin positivity rates were similar when compared to controls. Pseudothrombocytopenia was frequently misdiagnosed, which led to inappropiate treatments. Therefore, this situation should be kept in mind.

The increased risk for thrombosis is known as hypercoagulability or thrombophilia. Here, we investigated risk factors for thrombophilia which were screened in young adult patients presenting with thrombotic events or with recurrent abortions with unknown etiology. A total of 115 patients aged between 16 and 50 years who were found to harbor thrombophilia were retrospectively evaluated. The laboratory investigations performed for the assessment of thrombophilia included protein C, protein S, antithrombin III deficiencies, activated protein C resistance, factor V Leiden (FVL), prothrombin 20210A (PT 20210) and methylenetetrahydrofolate reductase (MTHFR) gene mutations, factor VIII elevation, lupus anticoagulant and antiphospholipid antibodies (APA). In 66% of the cases a single thrombophilic defect was identified while some of the patients had combined thrombophilic defects. The most common thrombophilic defect was mutation in the MTHFR gene, and was followed by FVL mutation, the presence of APA and PT 20210 gene mutation, respectively. The patients were divided into two different age groups, 16-35 and 36-50 years, and arterial thrombosis was more common in the older age group. Our results indicated that some important thrombophilic defects such as gene mutations may appear in young adult patients presenting with thrombotic events.