Maha Othman
@queensu.ca
Professor
Queen University
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Sydney Penfound, Alexandra Lukey, Jessica Hodgson, Wilma M. Hopman, Gillian E. Hanley, and Maha Othman
Elsevier BV
Yousra Tera, Yoon Jin Suh, Karina Fainchtein, Anita Agrawal, Mihaela Mates, and Maha Othman
Wiley
AbstractVenous thromboembolism (VTE) is a common occurrence in cancer and chemotherapy increases thrombosis risk. Current risk assessment models such as the Khorana score (KS) and its modifications have limitations in female cancers. We assessed the coagulation profile of a group of women cancer patients under chemotherapy using thromboelastography (TEG) to determine if this can inform VTE risk assessment. Cancer patients who planned to receive chemotherapy were recruited. Baseline demographics, cancer data, BMI, Khorana Score (KS), and VTE risk factors were recorded and patients were followed for 6 months, for any thrombotic events. A total of 36 patients aged 35–85 (18 breast, 11 endometrial, 7 ovarian cancer) were evaluated. Hypercoagulability was detected in 63% of patients post‐chemo cycle 1 and 75% post‐cycle 2, with a significant increase in MA (maximum amplitude) and CI (clotting index), reduction in R (reaction time), K (clot kinetics), and LY30 (lysis time after 30 min of MA). KS showed only 7% of patients were high risk, 23% were low, and 70% were intermediate risk. MA and CI significantly increased in patients with intermediate and high‐risk KS when compared with the low‐risk patients and MA was positively correlated with KS. Five patients developed actual VTE; 100% of the tested ones were hypercoagulable either post‐cycle 1 or 2 and 80% were KS intermediate risk. TEG is a hypercoagulability marker and TEG‐MA and CI can potentially assess VTE risk. Larger studies are needed to assess the utility of TEG as an adjuvant to KS to better predict VTE in specific female cancers.
Salah Elsherif, Ali Zidan, Olivia Saville, and Maha Othman
Georg Thieme Verlag KG
AbstractCancer-associated thrombosis (CT), especially venous thromboembolism (VTE), is a common occurrence with several factors contributing to a wide diversity in thrombosis risk. The association between ABO blood groups and the risk for CT has been examined in various studies, with non-O blood type associated with an increased thrombosis risk; however, these studies have reported varying results with recognized limitations. ABO blood groups are known to be implicated in hemostasis, in an association mediated through von Willebrand factor (VWF). In this narrative review, we aim to summarize the current knowledge surrounding the role of ABO blood groups in VTE, with a particular focus on the role of VWF and other contributing risk factors on VTE occurrence. We found evidence from literature for the impact of ABO blood groups in determining the risk of VTE in healthy populations, with a limited number of studies examining this effect in cancer patients. Additionally, research on the impact of ABO on different cancer types lacks rigor, particularly in regard to other risk factors. Overall, most studies showed strong association of increased risk of VTE amongst cancer patients with non-O blood groups and increased VWF levels. This association was weaker in a few studies. Further research is needed before a solid conclusion can be made about the ABO or ABO-VWF-mediated hypercoagulability and VTE risk in various cancers. These studies will help determine if ABO typing can be an added biomarker to improve VTE risk assessment models in cancer patients.
Ross I. Baker, Philip Choi, Nicola Curry, Johanna Gebhart, Keith Gomez, Yvonne Henskens, Floor Heubel-Moenen, Paula James, Rezan Abdul Kadir, Peter Kouides,et al.
Elsevier BV
Adham H. El-Sherbini, Stefania Coroneos, Ali Zidan, and Maha Othman
Georg Thieme Verlag KG
AbstractKhorana score (KS) is an established risk assessment model for predicting cancer-associated thrombosis. However, it ignores several risk factors and has poor predictability in some cancer types. Machine learning (ML) is a novel technique used for the diagnosis and prognosis of several diseases, including cancer-associated thrombosis, when trained on specific diagnostic modalities. Consolidating the literature on the use of ML for the prediction of cancer-associated thrombosis is necessary to understand its diagnostic and prognostic abilities relative to KS. This systematic review aims to evaluate the current use and performance of ML algorithms to predict thrombosis in cancer patients. This study was conducted per Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Databases Medline, EMBASE, Cochrane, and ClinicalTrials.gov, were searched from inception to September 15, 2023, for studies evaluating the use of ML models for the prediction of thrombosis in cancer patients. Search terms “machine learning,” “artificial intelligence,” “thrombosis,” and “cancer” were used. Studies that examined adult cancer patients using any ML model were included. Two independent reviewers conducted study selection and data extraction. Three hundred citations were screened, of which 29 studies underwent a full-text review, and ultimately, 8 studies with 22,893 patients were included. Sample sizes ranged from 348 to 16,407 patients. Thrombosis was characterized as venous thromboembolism (n = 6) or peripherally inserted central catheter thrombosis (n = 2). The types of cancer included breast, gastric, colorectal, bladder, lung, esophageal, pancreatic, biliary, prostate, ovarian, genitourinary, head–neck, and sarcoma. All studies reported outcomes on the ML's predictive capacity. The extreme gradient boosting appears to be the best-performing model, and several models outperform KS in their respective datasets.
Maha Othman, Georgiana Nemeti, Marissa Solow, Gheorghe Cruciat, Daniel Muresan, Mariam Suzana Chaikh Sulaiman, Shivani Thaker, Rezan Abdul-Kadir, and A. Kinga Malinowski
Elsevier BV
Hanaa Ali EL-Sayed, Maha Othman, Hanan Azzam, Regan Bucciol, Mohamed Awad Ebrahim, Mohammed Ahmed Mohammed Abdallah EL-Agdar, Yousra Tera, Doaa H. Sakr, Hayam Rashad Ghoneim, and Tarek El-Sayed Selim
Springer Science and Business Media LLC
Regan Bucciol and Maha Othman
Ovid Technologies (Wolters Kluwer Health)
Purpose of review Cancer-associated thrombosis (CAT), such as venous thromboembolism (VTE), is a frequent complication in cancer patients, resulting in poor prognosis. Breast cancer is not highly thrombogenic but is highly prevalent, resulting in increased VTE cases. Many cancers express tissue factor (TF), a glycoprotein that triggers coagulation. The cancer cells were shown to express and release substantial amounts of TF-positive microparticles (MPTF), associated with a prothrombotic state. This narrative review evaluated the current use of the procoagulant MPTF as a biomarker for thrombosis risk in breast cancer. Recent findings Tumors of epithelial origin with elevated TF expression have been associated with increased VTE incidence. Thus, studies have affirmed the use of MPTF biomarkers for VTE risk in many cancers. Patients with metastatic breast cancer and CAT were found to exhibit elevated procoagulant microparticles in vitro, due to TF expression. The silencing of TF was associated with decreased microparticle release in breast carcinoma cell lines, associated with decreased coagulation. Summary CAT is a multifactorial condition, with several various underlying diseases. It is proposed that MPTF may be an effective biomarker for thrombosis risk in breast cancer patients but requires a more systemic evaluation utilizing standardized quantification methods.
Helen C. Okoye, Maha Othman, Theresa U. Nwagha, Daniel N. Onwusulu, Robinson C. Onoh, and Chibuike O. Chigbu
Wiley
OBJECTIVE
To evaluate the hemostatic effects of tranexamic acid (TXA) ex vivo in women with pre-eclampsia.
METHODS
This was an ex vivo study involving 45 normal pregnant women and 45 women with pre-eclampsia (nine with mild and 36 with severe features) matched for age, gestational age, and body mass index. Blood samples were collected and divided into two parts. The first served as the pre-TXA sample, while the second was spiked with TXA and served as the post-TXA sample. Plasma levels of D-dimer and plasmin-antiplasmin complex (PAP) were determined using enzyme-linked immunosorbent assay.
RESULTS
The mean D-dimer and PAP values in the pre-TXA samples differed significantly between groups. Following spiking with TXA, the mean D-dimer and PAP levels did not differ significantly in the pre-TXA and post-TXA samples (P = 0.560 and P = 0.500, respectively) in the pre-eclampsia cohort. In normal pregnancy, the mean D-dimer and PAP levels in the post-TXA samples did not differ significantly (P = 0.070 and P = 0.050, respectively) from the pre-TXA samples following TXA spiking.
CONCLUSION
TXA did not significantly affect D-dimer and PAP levels in pre-eclampsia, suggesting that TXA may not increase the thrombotic risks in patients with pre-eclampsia.
Emmanuel J. Favaloro and Maha Othman
Elsevier BV
Elvira Grandone, Doris Barcellona, Mariano Intrieri, Giovanni Tiscia, Luigi Nappi, and Maha Othman
Georg Thieme Verlag KG
AbstractAssisted reproductive techniques (ART) allow infertile couples to conceive. Use of hormones to obtain a controlled ovarian stimulation and an adequate growth of the endometrium preparatory for embryo implantation are not riskless. Among others, thrombotic events can occur during the ovulation induction or pregnancy following ART. As the number of women approaching ART to conceive is steadily increasing, the issue of thrombotic risk in this setting is relevant. Data on the weight of each risk factor and on potential benefit of thromboprophylaxis are largely lacking. In this review, we discuss risk of venous thromboembolism during pregnancy following ART, with a focus on general (i.e.: age, body mass index, thrombophilia, bed rest, transfusions) and ART-specific (i.e., polycystic ovarian syndrome, ovarian hyperstimulation syndrome) risk factors. We also attempt to provide some suggestions to guide clinical practice, based on available data and studies performed outside ART.
Karyn Megy, Kate Downes, Marie-Christine Morel-Kopp, José M. Bastida, Shannon Brooks, Loredana Bury, Eva Leinoe, Keith Gomez, Neil V. Morgan, Maha Othman,et al.
Elsevier BV
Maha Othman, Alexander T. Baker, Elena Gupalo, Abdelrahman Elsebaie, Carly M. Bliss, Matthew T. Rondina, David Lillicrap, and Alan L. Parker
Elsevier BV
Michelle Lavin, Analia Sánchez Luceros, Peter Kouides, Rezan Abdul-Kadir, James S. O’Donnell, Ross I. Baker, Maha Othman, and Sandra L. Haberichter
Elsevier BV
Skylar Tierney, Yan Deng, Alysha Geauvreau, Natalie Kearn, Jessica Hodgson, and Maha Othman
Elsevier BV
Adrian Minford, Leonardo R. Brandão, Maha Othman, Christoph Male, Rezan Abdul-Kadir, Paul Monagle, Andrew D. Mumford, Dorothy Adcock, Björn Dahlbäck, Predrag Miljic,et al.
Elsevier BV
Adrian Minford, Leonardo R. Brand˜ao, Maha Othman, Christoph Male, Rezan Abdul-Kadir, Paul Monagle, Andrew D. Mumford, Dorothy Adcock, Björn Dahlbäck, Predrag Miljic,et al.
Elsevier BV
Karina Fainchtein, Yousra Tera, Natalie Kearn, Abdelrahman Noureldin, and Maha Othman
Georg Thieme Verlag KG
AbstractThrombosis is one of the leading causes of death in cancer. Cancer-induced hypercoagulable state contributes to thrombosis and is often overlooked. Prostate cancer may not be of high thrombogenic potential compared with other cancers, but its high prevalence brings it into focus. Pathological evidence for venous thromboembolisms (VTEs) in prostate cancer exists. Factors such as age, comorbidities, and therapies increase the VTE risk further. There is a need to systematically identify the risk of VTE in regard to patient-, cancer-, and treatment-related factors to risk stratify patients for better-targeted and individualized strategies to prevent VTE. Sensitive tests to enable such risk assessment are urgently required. There is sufficient evidence for the utility of thromboelastography (TEG) in cancer, but it is not yet part of the clinic and there is only limited data on the use of TEG in prostate cancer. One study revealed that compared with age-matched controls, 68.8% of prostate cancer patients demonstrated hypercoagulable TEG parameters. The absence of clinical guidelines is a limiting factor in TEG use in the cancer population. Cancer heterogeneity and the unique cancer-specific microenvironment in each patient, as well as determining the hypercoagulable state in each patient, are added limitations. The way forward is to combine efforts to design large multicenter studies to investigate the utility and clinical effectiveness of TEG in cancer and establish longitudinal studies to understand the link between hypercoagulable state and development of thrombosis. There is also a need to study low thrombogenic cancers as well as high thrombogenic ones. Awareness among clinicians and understanding of test applicability and interpretation are needed. Finally, expert discussion is critical to identify the investigation priorities.
Ali Zidan, Abdelrahman Noureldin, Shreya Anil Kumar, Abdelrahman Elsebaie, and Maha Othman
Georg Thieme Verlag KG
AbstractVaccine-induced immune thrombotic thrombocytopenia (VITT) has been reported in association with the coronavirus disease 2019 preventative adenovirus vector-based vaccines ChAdOx1 nCoV-19 (Oxford/AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson) in hundreds of recipients across the globe. VITT is characterized by thrombosis, typically at unusual sites, low fibrinogen, and elevated plasma D-dimer, generally manifesting between 4 and 28 days following vaccination. Detection of anti-platelet factor antibodies using an enzyme-linked immunosorbent assay (ELISA) is often confirmatory. Although several similar principles subside in most diagnostic criteria for VITT, the presentation of a positive ELISA assay, use of expert hematology and neurology opinion, and exclusion of possible VITT cases outside the “standard” 4 to 28-day timeframe have contributed a lack of global standardization for defining VITT. Accordingly, the global and regional incidence of VITT differs according to the diagnostic pathway and case definition used. This has influenced the public perception of VITT's severity and the decision to use adenovirus vector-based vaccines for limiting severe acute respiratory syndrome coronavirus 2 infection. We hereby delineate the recognized pathogenic mechanisms, global incidence, discrepancies in diagnostic criteria, recommended treatments, and global implications to vaccine hesitancy from this coagulopathy.
Maha Othman and Anushka Pradhan
Springer US
Olivia Saville, Malak Elbatarny, Yousra Tera, Yan Deng, and Maha Othman
Elsevier BV
Predrag Miljic, Abdelrahman Noureldin, Michelle Lavin, Sajida Kazi, Analia Sanchez-Luceros, Paula D. James, and Maha Othman
Elsevier BV
Takafumi Ushida, Tiziana Cotechini, Nicole Protopapas, Aline Atallah, Charlotte Collyer, Alexa J. Toews, Shannyn K. Macdonald-Goodfellow, M. Yat Tse, Louise M. Winn, Stephen C. Pang,et al.
Cambridge University Press (CUP)
The title of the article mistakenly read; Aberrant inflammation in rat pregnancy leads to cardiometabolic alterations in their offspring and intrauterine growth restriction in the F2 generation. The correct title should read; Aberrant inflammation in rat pregnancy leads to cardiometabolic
Takafumi Ushida, Tiziana Cotechini, Nicole Protopapas, Aline Atallah, Charlotte Collyer, Alexa J. Toews, Shannyn K. Macdonald-Goodfellow, M. Yat Tse, Louise M. Winn, Stephen C. Pang,et al.
Cambridge University Press (CUP)
AbstractChildren of women with pre-eclampsia have increased risk of cardiovascular (CV) and metabolic disease in adult life. Furthermore, the risk of pregnancy complications is higher in daughters born to women affected by pre-eclampsia than in daughters born after uncomplicated pregnancies. While aberrant inflammation contributes to the pathophysiology of pregnancy complications, including pre-eclampsia, the contribution of maternal inflammation to subsequent risk of CV and metabolic disease as well as pregnancy complications in the offspring remains unclear. Here, we demonstrate that 24-week-old female rats (F1) born to dams (F0) exposed to lipopolysaccharide (LPS) during pregnancy (to induce inflammation) exhibited mild systolic dysfunction, increased cardiac growth-related gene expression, altered glucose tolerance, and coagulopathy; whereas male F1 offspring exhibited altered glucose tolerance and increased visceral fat accumulation compared with F1 sex-matched offspring born to saline-treated dams. Both male and female F1 offspring born to LPS-treated dams had evidence of anemia. Fetuses (F2) from F1 females born to LPS-treated dams were growth restricted, and this reduction in fetal growth was associated with increased CD68 positivity (indicative of macrophage presence) and decreased expression of glucose transporter-1 in their utero-placental units. These results indicate that abnormal maternal inflammation can contribute to increased risk of CV and metabolic disease in the offspring, and that the effects of inflammation may cross generations. Our findings provide evidence in support of early screening for CV and metabolic disease, as well as pregnancy complications in offspring affected by pre-eclampsia or other pregnancy complications associated with aberrant inflammation.
Hau C. Kwaan, Mark Walsh, Paul F. Lindholm, and Maha Othman
Georg Thieme Verlag KG